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  1. Al-Yateem N, Hijazi H, Saifan AR, Ahmad A, Masa'Deh R, Alrimawi I, et al.
    BMJ Open, 2023 Dec 22;13(12):e076326.
    PMID: 38135338 DOI: 10.1136/bmjopen-2023-076326
    OBJECTIVES: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice.

    DESIGN: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language.

    SETTING: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023.

    PARTICIPANTS: 14 purposively selected healthcare practitioners.

    INTERVENTION: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews.

    PRIMARY AND SECONDARY OUTCOMES: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being.

    RESULTS: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied.

    CONCLUSIONS: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

  2. Siddique S, Chaudhry MN, Ahmad SR, Nazir R, Javed R, Hafeez MR, et al.
    Sci Total Environ, 2024 Feb 20;912:169256.
    PMID: 38101629 DOI: 10.1016/j.scitotenv.2023.169256
    A pioneering study employed a holistic geostatistical approach to predict the spatial variability of a non sampled area in the Chenab River, Pakistan, using kriging interpolation for organochlorine pesticide (OCP)-polluted risk zones. The Present research intended to investigate the carcinogenic and non-carcinogenic human health risks, contamination levels, and spatial variation of OCPs in the Chenab River, Pakistan. The residual OCP content in sediment samples (n = 120) ranged from 0.056 to 32.14 ng/g. DDE and α-HCH were prevalent among all the samples analyzed, with mean concentrations of 15.84 ± 8.02 and 12.45 ± 6.72 ng/g, respectively. The order of magnitude of OCPs in sediment samples was DDTs > α-HCH > chlorothalonil > heptachlor > endosulfan > aldrin > dieldrin. The findings of the single (SPI) and Nemerow (Nel) pollution index of α-HCH, heptachlor, and aldrin depicted the Chenab River as a serious pollution risk zone. The outcomes of the Pearson correlation coefficient analysis represent the positive correlation among all OCPs, revealing the common origin. Distribution trends showed substantially higher (p 10-4 illustrated a substantial cancer health risk posed by α-HCH, heptachlor, aldrin, and dieldrin in the downstream zone. We recommend the urgent cessation of the ongoing discharge of OCPs into the Chenab River, which needs to be highlighted owing to the significant cancer risk to public health to ensure the good health and wellbeings.
  3. Heikal MF, Putra WE, Sustiprijatno, Rifa'i M, Hidayatullah A, Ningsih FN, et al.
    Trop Life Sci Res, 2023 Jun;34(2):1-20.
    PMID: 38144376 DOI: 10.21315/tlsr2023.34.2.1
    Malaria continues to be a major public health issue in a number of countries, particularly in tropical regions-the emergence of drug-resistant Plasmodium falciparum encourages new drug discovery research. The key to Plasmodium falciparum survival is energy production up to 100 times greater than other parasites, primarily via the PfLDH. This study targets PfLDH with natural bioactive compounds from the Zingiberaceae family through molecular docking and molecular dynamic studies. Sulcanal, quercetin, shogosulfonic acid C, galanal A and naringenin are the Top 5 compounds with a lower binding energy value than chloroquine, which was used as a control in this study. By binding to NADH and substrate binding site residues, the majority of them are expected to inhibit pyruvate conversion to lactate and NAD+ regeneration. When compared to sulcanal and control drugs, the molecular dynamics (MD) simulation study indicated that quercetin may be the most stable molecule when interacting with PfLDH.
  4. Kumar P, Abubakar AA, Verma AK, Umaraw P, Adewale Ahmed M, Mehta N, et al.
    Crit Rev Food Sci Nutr, 2023 Nov;63(33):11830-11858.
    PMID: 35821661 DOI: 10.1080/10408398.2022.2096562
    Treating livestock as senseless production machines has led to rampant depletion of natural resources, enhanced greenhouse gas emissions, gross animal welfare violations, and other ethical issues. It has essentially instigated constant scrutiny of conventional meat production by various experts and scientists. Sustainably in the meat sector is a big challenge which requires a multifaced and holistic approach. Novel tools like digitalization of the farming system and livestock market, precision livestock farming, application of remote sensing and artificial intelligence to manage production and environmental impact/GHG emission, can help in attaining sustainability in this sector. Further, improving nutrient use efficiency and recycling in feed and animal production through integration with agroecology and industrial ecology, improving individual animal and herd health by ensuring proper biosecurity measures and selective breeding, and welfare by mitigating animal stress during production are also key elements in achieving sustainability in meat production. In addition, sustainability bears a direct relationship with various social dimensions of meat production efficiency such as non-market attributes, balance between demand and consumption, market and policy failures. The present review critically examines the various aspects that significantly impact the efficiency and sustainability of meat production.
  5. Adibah Yusof NA, Abdul Karim MK, Asikin NM, Paiman S, Awang Kechik MM, Abdul Rahman MA, et al.
    Curr Med Imaging, 2023;19(10):1105-1113.
    PMID: 35975862 DOI: 10.2174/1573405618666220816160544
    BACKGROUND: For almost three decades, computed tomography (CT) has been extensively used in medical diagnosis, which led researchers to conduct linking of CT dose exposure with image quality.

    METHODS: In this study, a systematic review and a meta-analysis study were conducted on CT phantom for resolution study especially based on the low contrast detectability (LCD). Furthermore, the association between the CT parameter such as tube voltage and the type of reconstruction algorithm, the amount of phantom scanning affecting the image quality and the exposure dose were also investigated in this study. We utilize PubMed, ScienceDirect, Google Scholar and Scopus databases to search related published articles from the year 2011 until 2020. The notable keywords comprise "computed tomography", "CT phantom", and "low contrast detectability". Of 52 articles, 20 articles are within the inclusion criteria in this systematic review.

    RESULTS: The dichotomous outcomes were chosen to represent the results in terms of risk ratio as per meta-analysis study. Notably, the noise in iterative reconstruction (IR) reduced by 24%, 33% and 36% with the use of smooth, medium and sharp filters, respectively. Furthermore, adaptive iterative dose reduction (AIDR 3D) improved image quality and the visibility of smaller less dense objects compared to filtered back-projection. Most of the researchers used 120 kVp tube voltage to scan phantom for quality assurance study.

    CONCLUSION: Hence, optimizing primary factors such as tube potential reduces the dose exposure significantly, and the optimized IR technique could substantially reduce the radiation dose while maintaining the image quality.

  6. Sokama-Neuyam YA, Yusof MAM, Owusu SK, Darkwah-Owusu V, Turkson JN, Otchere AS, et al.
    Sci Rep, 2023 Jun 06;13(1):9155.
    PMID: 37280365 DOI: 10.1038/s41598-023-36419-3
    A viable CO2 storage resource must have sufficient storage capacity, reliable containment efficiency and adequate well injectivity. Deep saline formations stand out in terms of storage capacity and containment efficiency. However, formation brine dry-out and salt precipitation in the near well region could impair CO2 injectivity in deep saline reservoirs, thus reducing their potential for CO2 storage. Core-flood experiments and analytical modelling were used to investigate various mechanisms of external and internal salt precipitation. Particularly, the impact of the extension of the dry-out region on CO2 injectivity was investigated. It was found that, for high permeability rocks, injection of CO2 at relatively low injection rates could result in salt cake deposition at the injection inlet especially under high salinity conditions. It was also found that extension of the dry-out region does not have significant impact on CO2 injectivity. Although the magnitude of CO2 injectivity impairment increased more than two-fold when initial brine salinity was doubled, real-time changes in CO2 injectivity during the drying process was found to be independent of initial brine salinity. We have shown that the bundle-of-tubes model could provide useful insight into the process of brine vaporization and salt deposition in the dry-out region during CO2 injection. This work provides vital understanding of the effect of salt precipitation on CO2 injectivity.
  7. Ismail A, Reffien MAM, Ibrahim NM, Sobri HNM, Abidin NDIZ, Rusli SASS, et al.
    Glob J Qual Saf Healthc, 2020 Nov;3(4):134-138.
    PMID: 37260578 DOI: 10.36401/JQSH-20-10
    INTRODUCTION: Globally, stroke continues to become a significant public health issue contributing to one of the significant causes of morbidity and mortality. The study aimed to describe the characteristics of patients with stroke who were admitted to a teaching hospital in Malaysia and to determine the factors associated with length of stay (LOS).

    METHODS: This is a single-center, cross-sectional study using in-patient data maintained by the Case-Mix Unit of a teaching hospital in Malaysia from 2016 to 2017. The study included all patients with International Classification of Disease (ICD) code 164 (stroke, not specified as hemorrhage or infarct). The significance of association was determined using nonparametric tests in the form of the Mann-Whitney U test and the Kruskal-Wallis test.

    RESULTS: A total of 162 stroke patients from 2016 to 2017 from Case-Mix database were included in the study. The age ranged from 31 to 97 years old. The minimum and maximum LOS for patients with stroke ranged from 1 to 17 days. The severity of illness was found to be significantly associated with longer LOS (p < 0.001); however, age, sex, and presence of co-morbidities did not show any significant association.

    CONCLUSION: Despite its limitations, this study is an essential first step to examine the characteristics of patients with stroke and to determine the factors associated with LOS.

  8. Alias N, Ali Umar A, Sadikin SN, Ridwan J, Hamzah AA, Ali Umar MI, et al.
    ACS Omega, 2023 May 30;8(21):18874-18881.
    PMID: 37273642 DOI: 10.1021/acsomega.3c01236
    Perovskite solar cells have emerged as a potential energy alternative due to their low cost of fabrication and high power conversion efficiency. Unfortunately, their poor ambient stability has critically limited their industrialization and application in real environmental conditions. Here, we show that by introducing hexamine molecules into the perovskite lattice, we can enhance the photoactive phase stability, enabling high-performance and air-processable perovskite solar cells. The unencapsulated and freshly prepared perovskite solar cells produce a power conversion efficiency of 16.83% under a 100 mW cm-2 1.5G solar light simulator and demonstrate high stability properties when being stored for more than 1500 h in humid air with relative humidity ranging from 65 to 90%. We envisage that our findings may revolutionize perovskite solar cell research, pushing the performance and stability to the limit and bringing the perovskite solar cells toward industrialization.
  9. Teo SH, Ong TK, Merican AM, Hashim MS, Ng WM, Al-Fayyadh MZM, et al.
    Indian J Orthop, 2023 Jun;57(6):847-855.
    PMID: 37214363 DOI: 10.1007/s43465-023-00874-x
    BACKGROUND: Accurate planning for patellar instability correction is important in obtaining good post-operative outcome. The main challenge in the current two-dimensional (2-D) computed tomographic (CT) scans method is the difficulty in choosing reliable bony landmarks. This study aimed to compare the reliabilities between the 2-D and three-dimensional (3-D) methods of measuring tibial tubercle-trochlear groove (TT-TG) distance. We hypothesize that the proposed 3-D method will result in measurements with narrower error margin, providing higher reliability and accuracy.

    MATERIALS AND METHODS: We traced CT scans of 106 knees with no patellofemoral pathology from 59 subjects from the database system and converted all 2-D images into 3-D models to determine the values for each parameter. We compared the intra- and interobserver reliability of each method using intraclass correlation (ICC) and Bland-Altman method.

    RESULTS: The values of TT-TG measured by 2-D and 3-D methods were 16.1 ± 4.6 mm and 16.2 ± 4.2 mm, respectively. The ICC values of both methods were comparable (95% limits of agreement between the same observer: - 3.3 to 3.8 mm versus - 2.4 to 2.7 mm and different observers: - 4.3 to 4.9 mm versus - 3.9 to 2.7 mm), with 3-D method results in narrower limits of agreement.

    CONCLUSION: TT-TG measurement is reliable using the 2-D method without using advanced radiographic software. The 3-D method of measuring TT-TG provides measurement with narrower variation when compared with the 2-D method. However, both TT-TG distances' measurement methods in the current study were comparable as the variations are not significant.

  10. Anuar NS, Shafie SA, Maznan MAF, Zin NSNM, Azmi NAS, Raoof RA, et al.
    Toxicol Appl Pharmacol, 2023 Jul 01;470:116558.
    PMID: 37211320 DOI: 10.1016/j.taap.2023.116558
    Lauric acid, a 12‑carbon atom medium chain fatty acid (MCFA) has strong antioxidant and antidiabetic activities. However, whether lauric acid can ameliorate hyperglycaemia-induced male reproductive damage remains unclear. The study aimed to determine the optimal dose of lauric acid with glucose-lowering activity, antioxidant potential and tissue-protective effects on the testis and epididymis of streptozotocin (STZ)-induced diabetic rats. Hyperglycaemia was induced in Sprague Dawley rats by an intravenous injection of STZ at a dose of 40 mg/kg body weight (bwt). Lauric acid (25, 50 and 100 mg/kg bwt) was administered orally for eight weeks. Weekly fasting blood glucose (FBG), glucose tolerance and insulin sensitivity were examined. Hormonal profiles (insulin and testosterone), lipid peroxidation (MDA) and antioxidant enzyme (SOD and CAT) activities were measured in the serum, testis and epididymis. The reproductive analyses were evaluated based on sperm quality and histomorphometry. Lauric acid administration significantly improved FBG levels, glucose tolerance, hormones-related fertility and oxidant-antioxidant balance in the serum, testis and epididymis compared to untreated diabetic rats. Treatment with lauric acid preserved the testicular and epididymal histomorphometry, along with the significant improvements in sperm characteristics. It is shown for the first time that lauric acid treatment at 50 mg/kg bwt is the optimal dose for ameliorating hyperglycaemia-induced male reproductive complications. We conclude that lauric acid reduced hyperglycaemia by restoring insulin and glucose homeostasis, which attributes to the regeneration of tissue damage and sperm quality in STZ-induced diabetic rats. These findings support the correlation between oxidative stress and hyperglycaemia-induced male reproductive dysfunctions.
  11. Lih Yuan T, Sulaiman N, Nur Azurah AG, Maarof M, Razali RA, Koh B, et al.
    Int J Mol Sci, 2023 May 15;24(10).
    PMID: 37240142 DOI: 10.3390/ijms24108798
    Infertility is a condition affecting women who are born with an underdeveloped or absent vagina, a birth defect known as congenital absence of the vagina. It is a rare disorder where the development of the Mullerian duct is obstructed by unidentified causes. The case is seldom reported due to the low prevalence and sparse epidemiology studies worldwide. A potential solution for the disorder is neovaginal creation with in vitro cultured vaginal mucosa. Limited studies have reported its application, but none are reproducible or specific regarding the established processes for acquiring vaginal epithelial cells from vaginal biopsies. These research gaps were adequately answered with an epidemiology study of inpatient details in Hospital Canselor Tuanku Muhriz, Malaysia, established methods and outcomes of vaginal tissue processing and isolation, and characterization of vaginal epithelial cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and immunofluorescence assays. The reported evidence and speculation that the disorder arises because of a cellular transition event between epithelial and mesenchymal cells during the development of the Mullerian duct could be key in the creation of neovaginas using established culture procedures to improve surgical results and restore fertility.
  12. Abdul Jabar MH, Srivastava R, Abdul Manaf N, Thangalazhy-Gopakumar S, Ab Latif FE, Luu MT, et al.
    Environ Sci Pollut Res Int, 2023 Nov;30(55):116934-116951.
    PMID: 37221293 DOI: 10.1007/s11356-023-27641-7
    Solar photovoltaic-thermal hybrid with phase change material (PVT-PCM) emerges as an intelligent game changer to stimulate the clean, reliable, and affordable renewable energy technology. This PVT-PCM technology can be manipulated into generating both electricity and thermal energy that feature its practicality for residential and industrial applications. Hybridized of PCM into PVT design adds value to existing architecture with its capability to store excess heat that can be used during insufficient solar irradiation. Present work gives overview of the PVT-PCM system on technology innovation toward commercialization (viz, solar end game) subjected to bibliometric analysis, research and development evolution, and patent activity. A consolidation of these review articles was decluttered to focus on the performance and efficiency of PVT-PCM technology based on the fact that commercialization is ready once the technology is completed and qualified (at technology readiness level, TRL: 8). Economic review was conducted to understand the feasibility of the existing solar technologies and how it affects the PVT-PCM market price. Based on the contemporary findings, promising performance of PVT-PCM technology has underpinned its feasibility and technology readiness. China has predominant local and international framework and expected to be the PVT-PCM technology trendsetter in the next years through its strong international collaborative projects and pioneer in PVT-PCM patent filing. This present work underscores the solar end-game strategy and recommendation to create a path forward to achieve clean energy transition. Though, as to the date of submission of this article, no industry  has found to manufacture/sell this hybrid technology in the market.
  13. Putra NR, Rizkiyah DN, Aziz AHA, Mamat H, Jusoh WMSW, Idham Z, et al.
    Sci Rep, 2023 Jul 05;13(1):10871.
    PMID: 37407592 DOI: 10.1038/s41598-023-32181-8
    The purpose of this work was to establish the best particle size for recovering high yields of total phenolic compounds (TPC), total anthocyanin compounds(TAC) and total flavonoid compounds (TFC) from roselle (Hibiscus sabdariffa) by applying supercritical carbon dioxide (ScCO2). The extraction rate, diffusivity and solubility of yield in ScCO2 were also studied and calculated utilizing models. Pressure (10 and 30 MPa), temperature (40 and 60 °C), and particle size (250 µm 
  14. Johari MIH, Zulperi D, Saad N, Ismail SI, Jamian S, Abdullah S, et al.
    Plant Dis, 2023 Nov 08.
    PMID: 37938907 DOI: 10.1094/PDIS-07-23-1278-PDN
    Ceylon ironwood (Mesua ferrea Linn.) or Penaga lilin is one of Asia's most popular tropical herbal plants, including Malaysia (Sharma et al., 2017). The trees are cultivated for their aesthetic value and pharmacological properties, especially as traditional remedies for asthma, dermatopathy, inflammation, and rheumatic conditions (Adib et al., 2019). In August 2022, a disease survey was conducted on Ceylon ironwood trees ranging from 5 to 12 years old in Botanical Park, Putrajaya, Malaysia, with 80% exhibiting shoot dieback disease of the 15 trees exhibiting shoot dieback disease. Symptoms include irregular, water-soaked with brown lesions on young leaves and shoots, where the small lesion coalesced and formed broad necrotic regions, subsequently causing dieback and gradual defoliation. Three infected shoots were collected from each tree, excised into small pieces (10 to 20 mm), immersed with 75% ethanol for 3 min, washed with 2% NaOCl solution for 1 min, and rinsed twice for 1 min in sterilized distilled water. A 10 µl aliquot of the sample suspension was streaked onto nutrient agar (NA) and incubated for 24 h to 48 h at 35 °C. A total of 15 isolates with similar morphology were obtained, and each isolate was re-streaked three times to obtain pure colonies that were round, smooth, with irregular edges, and produced yellow pigment in culture. All isolates were Gram-negative, negative for indole production, and utilized glucose, maltose, trehalose, sucrose, D-lactose, and pectin. Three representative isolates (C001, C002, and C003) with similar morphology were selected for further characterization. The total genomic DNA of all isolates was extracted from overnight cultures using Geneaid™ DNA Isolation Kit (Geneaid Biotech Ltd., Taiwan). PCR amplification of 16S rDNA (Zhou et al., 2015) and species-specific infB (Brady et al., 2008) genes was performed, and each of the ~1500 bp and ~900 bp amplicons were sequenced. BLASTn and phylogenetic analyses revealed all isolates were 100% identical to Pantoea anthophila (P. anthophila) LGM 2558 strains (Accession Nos. NR_116749 and NR_116113) for the 16S rDNA gene. They were 99% identical to P. anthophila CL1 strain (Accession Number CP110473) for infB gene. These sequences were later deposited in the GenBank (Accession Nos. OQ772233, OQ772234, and OQ772235 for 16S rDNA gene, and OQ803527, OQ803528, and OQ803529 for infB gene). For the pathogenicity test, healthy Ceylon ironwood seedlings' shoots were inoculated with 10 mL of each isolate suspension (1 x 108 CFU/ml) by spraying the inoculum on the young shoots using a sterilized spray bottle. Control seedlings were inoculated with sterile water. The inoculated shoots were covered with a sealed plastic bag to maintain the moisture and were kept in the greenhouse with temperatures ranging from 26 to 35 °C. The experiments were repeated twice, with three replicates for each treatment. Inoculated shoots showed dieback symptoms like natural infection, including irregular, water-soaked, and brown lesions on leaves and young shoots at 10 days post-inoculation. Control seedlings remained asymptomatic. The pathogen was re-isolated and identified via sequencing of the 16S rDNA and infB genes, thus fulfilling Koch's postulates. Previously, P. anthophila has been reported to cause soft rot in wampee plants in China (Zhou et al., 2015) and leaf blight of cotton in Pakistan (Tufail et al., 2020). To our knowledge, this is the first report of P. anthophila causing shoot dieback disease of Ceylon ironwood trees in Malaysia. Plant disease management strategies need to be established to reduce losses due to P. anthophila infection since the pathogen could limit Ceylon ironwood tree production in Malaysia.
  15. Isaac P, Mutusamy P, Su Yin L, Jing Wei Y, Mohd Salleh F, Abu Bakar MALb, et al.
    PMID: 37933991 DOI: 10.1128/MRA.00680-23
    Lactococcus lactis is a beneficial lactic acid bacterium commonly studied for its probiotic properties and role in dairy production. Here, we present a complete genome of Lactococcus lactis D1_2, isolated from peat swamp forests. To discover the potential antimicrobial properties, the complete genome of the strain was sequenced and analyzed.
  16. Mailafiya MM, Abubakar K, Chiroma SM, Danmaigoro A, Zyoud TYT, Rahim EBA, et al.
    Food Sci Nutr, 2023 May;11(5):2211-2231.
    PMID: 37181299 DOI: 10.1002/fsn3.3096
    A substantial global health burden is associated with neurotoxicity caused by lead (Pb) exposure and the common mechanism of this toxicity is mainly via oxidative damage. Curcumin has remarkable pharmacological activities but remains clinically constrained due to its poor bioavailability when orally administered. Currently, cockle shell-derived calcium carbonate nanoparticle (CSCaCO3NP) is gaining more acceptance in nanomedicine as a nanocarrier to various therapeutics. This study aimed at investigating the ameliorative effect of curcumin-loaded CSCaCO3NP (Cur-CSCaCO3NP) on lead-induced neurotoxicity in rats. A total of 36 male Sprague-Dawley rats were randomly assigned into five groups. Each group consists of 6 rats apart from the control group which consists of 12 rats. During the 4 weeks induction phase, all rats received a flat dose of 50 mg/kg of lead while the control group received normal saline. The treatment phase lasted for 4 weeks, and all rats received various doses of treatments as follows: group C (Cur 100) received 100 mg/kg of curcumin, group D (Cur-CSCaCO3NP 50) received 50 mg/kg of Cur-CSCaCO3NP, and group E (Cur-CSCaCO3NP 100) received 100 mg/kg of Cur-CSCaCO3NP. The motor function test was carried out using the horizontal bar method. The cerebral and cerebellar oxidative biomarker levels were estimated using ELISA and enzyme assay kits. Lead-administered rats revealed a significant decrease in motor scores and SOD activities with a resultant increase in MDA levels. Furthermore, marked cellular death of the cerebral and cerebellar cortex was observed. Conversely, treatment with Cur-CSCaCO3NP demonstrated enhanced ameliorative effects when compared with free curcumin treatment by significantly reversing the aforementioned alterations caused by lead. Thus, CSCaCO3NP enhanced the efficacy of curcumin by ameliorating the lead-induced neurotoxicity via enhanced attenuation of oxidative stress.
  17. Waqas S, Harun NY, Arshad U, Laziz AM, Sow Mun SL, Bilad MR, et al.
    Chemosphere, 2024 Feb;349:140830.
    PMID: 38056711 DOI: 10.1016/j.chemosphere.2023.140830
    Membrane fouling is a critical bottleneck to the widespread adoption of membrane separation processes. It diminishes the membrane permeability and results in high operational energy costs. The current study presents optimizing the operating parameters of a novel rotating biological contactor (RBC) integrated with an external membrane (RBC + ME) that combines membrane technology with an RBC. In the RBC + ME, the membrane panel is placed external to the bioreactor. Response surface methodology (RSM) is applied to optimize the membrane permeability through three operating parameters (hydraulic retention time (HRT), rotational disk speed, and sludge retention time (SRT)). The artificial neural networks (ANN) and support vector machine (SVM) are implemented to depict the statistical modelling approach using experimental data sets. The results showed that all three operating parameters contribute significantly to the performance of the bioreactor. RSM revealed an optimum value of 40.7 rpm disk rotational speed, 18 h HRT and 12.4 d SRT, respectively. An ANN model with ten hidden layers provides the highest R2 value, while the SVM model with the Bayesian optimizer provides the highest R2. RSM, ANN, and SVM models reveal the highest R-square values of 0.97, 0.99, and 0.99, respectively. Machine learning techniques help predict the model based on the experimental results and training data sets.
  18. Zahidin MA, Abdul Razak NI, Mohd Noor NH, Johan MF, Zulkafli Z, Abdullah AD, et al.
    Cureus, 2023 Nov;15(11):e48533.
    PMID: 38073971 DOI: 10.7759/cureus.48533
    Immune thrombocytopenia (ITP) has been comprehensively studied and understood in Western Europe and various Asia-Pacific regions. However, the epidemiological and clinical-laboratory aspects of ITP in Malaysia remain limited and not well documented. Therefore, this study aims to evaluate the incidence and clinical parameters of ITP using 20-year retrospective data. Medical records for 205 consecutive adult patients with ITP between January 2000 and December 2022 were analyzed. A p-value of <0.05 is considered statistically significant. The majority were Malays (n=192, 93.7%) and females (n=150, 73.2%), with a male-to-female ratio of 1:2.73. One hundred thirty-two (64.4%) and 73 (35.6%) patients were diagnosed with primary ITP (pITP) and secondary ITP (sITP), respectively. Systemic lupus erythematosus (SLE) (n=23, 35.9%), antiphospholipid syndrome (APS) (n=5, 7.8%), and familial thrombocytopenia (n=5, 7.8%) were the top 3 comorbid conditions for ITP. The overall incidence was 1.80/100,000 person-years (95% confidence interval (CI): 1.56-2.07), and the incidences were higher in females than in males with pITP (1.78/100,000 person-years versus 0.70/100,000 person-years) and sITP (0.86/100,000 person-years versus 0.26/100,000 person-years). The median age for patients with pITP was significantly higher than for those with sITP (median: 44 versus 37 years, respectively) (p=0.026). However, there was no statistically significant difference in white blood cell (WBC) counts, hemoglobin (HB) counts, platelet (PLT) counts, absolute neutrophil counts (ANC), or hematocrit (HCT) counts between those with pITP and sITP at the time of diagnosis. The current study provides an overview of ITP epidemiology in northeastern Malaysia. We emphasize the critical need for further additional research, particularly at the state and national levels in the future.
  19. Ul Mustafa Z, Batool A, Ibrar H, Salman M, Khan YH, Mallhi TH, et al.
    Expert Rev Anti Infect Ther, 2024 Apr;22(4):229-240.
    PMID: 38146949 DOI: 10.1080/14787210.2023.2299387
    INTRODUCTION: Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR).

    METHODS: Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave.

    RESULTS: A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves.

    CONCLUSION: There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.

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