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Some clinical problems of a psychiatric day centre

Teoh CL, Woon TH, Sim SH

Med J Malaysia, 1973 Dec;28(2):80-3.
PMID: 4276264
Heavy metal contents in coastal water fishes of West Malaysia

Babji AS, Embong MS, Woon WW

Bull Environ Contam Toxicol, 1979 Dec;23(6):830-6.
PMID: 519067
Digestive enzymes secreted by the carnivorous plant Nepenthes macferlanei L

Tökés ZA, Woon WC, Chambers SM

Planta, 1974 Mar;119(1):39-46.
PMID: 24442407 DOI: 10.1007/BF00390820

At least two proteases are present in the secretion of the pitchers of Nepenthes macferlanei, a major one with an estimated molecular weight of 59000 and a minor one of 21000. The specificity of the major enzyme, nepenthesin, was broader than previously reported, and strikingly similar to that of pepsin. Lipase activity was also demonstrated, while no amylase activity was present.
An integrated life cycle multi-objective optimization model for health-environment-economic nexus in food waste management sector

Lin Z, Ooi JK, Woon KS

Sci Total Environ, 2022 Apr 10;816:151541.
PMID: 34774629 DOI: 10.1016/j.scitotenv.2021.151541

Food waste is a universal problem in many countries. In line with Sustainable Development Goals 7 and 12, it is crucial to identify a cost-effective food waste valorization management framework with the least human health and environmental impacts. However, studies on the synergistic effect of life cycle assessment and mathematical optimization interconnected with human health, environment, and economic are relatively few and far between; hence they cannot provide holistic recommendations to policymakers in developing environmental and economic feasibility of food waste management frameworks. Taking Malaysia as a case study, this study proposes a simple and deterministic model that integrates life cycle assessment and multi-objective mathematical optimization to unpack the health-environment-economic wellbeing nexus in food waste management sector. The model evaluates the life cycle human health, environmental, and economic impacts of five food waste disposal and valorization technologies: open landfill, sanitary landfill, aerated windrow composting, high-temperature drying sterilization, and anaerobic digestion, and identifies the optimal food waste valorization configuration solution in Malaysia. Based on the results modeled by SimaPro 9.0 and General Algebraic Modeling System with augmented ε-constraint, valorization of food waste into electricity via anaerobic digestion is the most favorable option, with 146% and 161% reduction of human health and ecosystems, respectively, as compared with open landfill. If cost is combined as an objective function with human health and ecosystems, high-temperature drying sterilization is the most attractive scenario due to the high livestock feed revenue. Among the 10 Pareto-optimal solutions, 9% sanitary landfill, 3% aerated windrow composting, 30% high-temperature drying sterilization, 30% anaerobic digestion to electricity, and 28% anaerobic digestion to cooking gas, is recommended as future food waste management configuration. The sensitivity results demonstrate that prices of electricity, cooking gas, and livestock feed affect the optimal configuration food waste management system.
Fulltext Practical psychiatry: Providing temporary psychiatric cover

Looi JC, Allison S, Woon L

Australas Psychiatry, 2023 Oct;31(5):659-661.
PMID: 37424206 DOI: 10.1177/10398562231188264

OBJECTIVE: Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors' clinical experience and the existing research literature.
CONCLUSIONS: There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist's assessment of the temporary role, and consideration of the local service conditions.
Chemical Constituents and Biological Activities of Piper as Anticancer Agents: A Review

Woon CK, Ahmad FB, Zamakshshari NH

Chem Biodivers, 2023 Sep;20(9):e202300166.
PMID: 37515318 DOI: 10.1002/cbdv.202300166

Cancer has become the primary cause of death worldwide, and anticancer drugs are used to combat this disease. Synthesis of anticancer drugs has limited success due to adverse side effects has made compounds from natural products with minimal toxicity gain much popularity. Piper species are known to have a biological effect on human health. The biological activity is due to Piper species rich with active secondary metabolites that can combat most diseases, including cancer. This review will discuss the phytochemistry of Piper species and their anticancer activity. The identification and characterization of ten active metabolites isolated from Piper species were discussed in detail and their anticancer mechanism. These metabolites were mainly found could inhibit anticancer through caspase and P38/JNK pathways. The findings discussed in this review support the therapeutic potential of Piper species against cancer due to their rich source of active metabolites with demonstrated anticancer activity.
Fulltext Post-COVID-19 pandemic and the Paris agreement: a socioeconomic analysis and carbon emissions forecasting in developed and developing countries

Hoy ZX, Leong JF, Woon KS

Clean Technol Environ Policy, 2023 Mar 18.
PMID: 37359167 DOI: 10.1007/s10098-023-02508-0

The COVID-19 pandemic caused profound impacts on the global economy, resulting in a sharp drop in carbon emissions as energy demand fell. The emissions reduction due to past extreme events often follows with a rebound after the economy recovers, but the pandemic's impacts on the long-term carbon emissions trend remain unknown. This study forecasts the carbon emissions of Group of Seven (G7) as developed countries and Emerging Seven (E7) as developing countries using socioeconomic indicators and artificial intelligence-powered predictive analytics to assess the pandemic's impacts on the long-term carbon trajectory curve and their progress toward achieving the Paris Agreement goals. Most E7's carbon emissions have strong positive correlations (> 0.8) with the socioeconomic indicators, whereas most G7's correlate negatively (> 0.6) due to their decoupled economic growth from carbon emissions. The forecasts show higher growth rates in the E7's carbon emissions after the rebound in the pandemic scenario compared to the pandemic-free scenario, while the impact on the G7's carbon emissions is negligible. The overall impact of the pandemic outbreak on long-term carbon emissions is small. Still, its short-term positive impact on the environment should not be misunderstood, and stringent emissions reduction policies must be implemented urgently to ensure the achievement of Paris Agreement goals.
GRAPHICAL ABSTRACT: Research methodology for assessing the pandemic's impacts on the G7 and E7 countries' long-term carbon trajectory curve.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10098-023-02508-0.
Fulltext The impact of Movement Control Order during the COVID-19 pandemic on lifestyle behaviours and body weight changes: Findings from the MyNutriLifeCOVID-19 online survey

Chin YS, Woon FC, Chan YM

PLoS One, 2022;17(1):e0262332.
PMID: 35041712 DOI: 10.1371/journal.pone.0262332

BACKGROUND: The COVID-19 pandemic lockdowns have affected daily lives of the communities worldwide. This study aims to determine the lifestyle behaviours and their associations with body weight changes among Malaysian adults during the Movement Control Order (MCO) due to COVID-19 pandemic.
METHODS: A total of 1319 Malaysian adults participated in this cross-sectional online survey. Information on anthropometric data including body weight and height, and lifestyle behaviours including eating pattern, physical activity, and sleep pattern were self-reported by the respondents. A multivariable generalised linear mixed model was used to assess the associations between lifestyle behaviours and body weight changes with adjustment of confounding factors; namely, age, sex, ethnicity, and body weight status before MCO.
RESULTS: During MCO, 41.2% of the respondents perceived that their eating patterns were healthier, but 36.3% reduced their physical activities, and 25.7% had a poorer sleep quality. Further, the proportion of adults who reported having lose weight (32.2%) was almost similar to those who reported having gained weight (30.7%). Lifestyle behaviours including less frequent practice of healthy cooking methods and lunch skipping were associated with weight gain, while less frequent consumption of high fat foods, more frequent physical activity, and good sleep latency were associated with lower risk of weight gain. In contrast, practicing healthy eating concept, skipped lunch, and more frequent physical activity were significantly associated with weight loss.
CONCLUSION: Lifestyle behaviours were associated with body weight changes during MCO. While the COVID-19 pandemic lockdown is necessary to prevent further spread of the disease, promoting healthy lifestyle practices during lockdown should be implemented for a healthy weight and better health.
Highly-sensitive graphene-based flexible pressure sensor platform

Muhammad Aniq Shazni, Lee MW, Lee HW

Sains Malaysiana, 2017;46:1155-1161.

In this work, graphene has been utilized as the sensing material for the development of a highly-sensitive flexible pressure sensor platform. It has been demonstrated that a graphene-based pressure sensor platform that is able to measure pressure change of up to 3 psi with a sensitivity of 0.042 psi-1 and a non-linearity of less than 1% has been accomplished. The developed device, which resides on a flexible platform, will be applicable for integration in continuous wearables health-care monitoring system for the measurement of blood pressure.
Fulltext Factors associated with rates of gestational weight gain among pregnant women in Batu Pahat District of Johor state, Malaysia

Woon Fui Chee, Yu Min Si, Chin Yit Siew

Malaysian Journal of Medicine and Health Sciences, 2019;15(201):33-39.
MyJurnal

Introduction: This cross-sectional study determines factors associated with the rates of gestational weight gain (GWG) among women in the second and third trimester of pregnancy. Methods: A total of 180 pregnant women (29.2 ± 4.3 years old) attending the maternal and child health clinics in Batu Pahat district were enrolled in the present study be- tween January and February, 2015. Information regarding demographic characteristics, obstetrical history, physical activity, and calorie intake was assessed through direct interview. Anthropometric data were collected from medical records. GWG rates were determined based on 2009 IOM recommendations. Results: Of the 180 pregnant women, 37.2% were at their second trimester and 62.8% were at the third trimester of pregnancy. While 53.3% of them had excessive GWG rate, 28.9% have inadequate GWG rate. More than half of the women (56.7%) were normal weight, 21.1% overweight, 14.4% underweight, and 7.8% obese before pregnant. The total mean activity and energy intake of the pregnant women were 195.9±94.2 MET-hour/week and 2365±709 kcal/day, respectively. The multinomial logistic model indicates that women who were overweight or obese at pre-pregnancy were seven times more likely to have excessive GWG rate (OR = 7.44, 95% CI = 2.07-26.66) as compared to women who were pre-pregnancy normal weight. Conclusions: About four in every five of the pregnant women had their GWG rates outside the IOM recommendations. Women who were overweight/obese at pre-pregnancy were at-risk of having excessive GWG rate, which underlines the importance of targeting these women for pre-conception counselling on GWG.
Fulltext Factors affecting Malaysian ESL teachers' behavioral intentions for technology use in the post-COVID-19 era

Chun TW, Yunus MM

Front Psychol, 2023;14:1127272.
PMID: 37034902 DOI: 10.3389/fpsyg.2023.1127272

This study aimed to investigate English as a Second Language (ESL) teachers' technology acceptance levels and to identify the factors affecting their behavioral intentions (BI) with respect to technology use in the post-COVID-19 era. A cross-sectional survey of 361 Malaysian ESL teachers was conducted. Participants were recruited via convenience sampling, and they answered an online survey questionnaire that was designed with reference to past studies. The collected data were analyzed via descriptive statistics, Pearson's correlation, and multiple regression analyses. The findings revealed that Malaysian ESL teachers generally had a high level of technology acceptance in the post-COVID-19 era. Their BIs had a significant relationship with three factors: performance expectancy (PE), effort expectancy (EE), and social influence (SI), of which EE was identified as the most significant factor influencing their BI with respect to technology use in the post-COVID-19 era. Conversely, the presence of facilitating conditions did not have a substantial connection with ESL teachers' behavioral intentions for technology use after the pandemic, despite the fact that there was weak positive relationship with each other. This study provides insights for the field of educational psychology by identifying the current trends in ESL teachers' behavioral intentions in adopting technology in the post-COVID-19-era ESL classrooms. The findings of this study may also support investigations into technology acceptance in ESL teaching, illustrating a growing need to provide adequate educational and technological tools, resources, and facilities to facilitate the delivery of lessons by ESL teachers. Future studies should conduct longitudinal research and investigate more variables from different technology acceptance models.
Fulltext Genome sequence of Dyella japonica strain A8, a quorum-quenching bacterium that degrades N-acylhomoserine lactones, isolated from Malaysian tropical soil

Chen JW, Chan KG

J Bacteriol, 2012 Nov;194(22):6331.
PMID: 23105069 DOI: 10.1128/JB.01637-12

Dyella japonica strain A8 is a Malaysian tropical soil bacterial strain which shows N-acylhomoserine lactone-degrading activity. Here, we present its draft genome sequence. A putative quorum-quenching gene was identified based on the genome sequence analysis of strain A8. To the best of our knowledge, this is the first genome announcement of a member from the genus of Dyella, and this is also the first work that reports the quorum-quenching activity of Dyella japonica.
Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia

Woon FC, Chin YS, Mohd Nasir MT

Obes Res Clin Pract, 2015 Jul-Aug;9(4):346-56.
PMID: 25476772 DOI: 10.1016/j.orcp.2014.10.218

This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10-11 years old) in Hulu Langat district, Selangor.
A randomised controlled trial of expectant management versus surgical evacuation of early pregnancy loss

Nadarajah R, Quek YS, Kuppannan K, Woon SY, Jeganathan R

Eur J Obstet Gynecol Reprod Biol, 2014 Jul;178:35-41.
PMID: 24813099 DOI: 10.1016/j.ejogrb.2014.02.021

To show whether a clinically significant difference in success rates exists between expectant and surgical management of early pregnancy loss.
Development of extraction procedures for the analysis of polycyclic aromatic hydrocarbons and organochlorine pesticides in municipal sewage sludge

Ahmad UK, Ujang Z, Woon CH, Indran S, Mian MN

Water Sci Technol, 2004;50(9):137-44.
PMID: 15581005

Land application of sludge as fertilizers is a way of disposal and recycling of sludge. However, public concern has arisen due to the fact that organic contaminants in sludge may ultimately enter the food chain. Hence the need arises to analyse the organic contaminants such as PAHs and OCPs in sludge. In this study, Soxhlet was utilised as the extraction method and the extracts subjected to extensive cleanup via either silica columns or solid phase extraction cartridges prior to analysis using gas chromatography or high performance liquid chromatography. Sludge samples were collected from the drying beds of oxidation ponds in three locations in South Johore. OCPs such as heptachlor, dieldrin and pp-DDT were detected in low amounts (52-159 mg/kg) whereas PAHs such as naphthalene, phenanthrene, fluoranthene and benzo(a)pyrene were detected in the range of 0.2-5.5 mg/kg dry mass. Subcritical water extraction (SWE) recovery studies of PAHs were also performed from spiked sludge samples. Although a recovery range of 41-68% was obtained using the SWE method, the results indicated the usefulness of the technique as an alternative to Soxhlet extraction for the analysis of PAHs in sludge samples.
Ovarian teratoma-associated anti-NMDAR encephalitis in a 12-year-old girl

Lwin S, San Yi M, Mardiana K, Woon SY, Nwe TM

Med J Malaysia, 2020 11;75(6):731-733.
PMID: 33219185

The association of ovarian teratoma and anti-N-Methyl-Daspartate receptor (anti-NMDAR) is one of the most common autoimmune encephalitis syndromes and it is a serious and potentially fatal pathology that occurs in young women. This case report describes of a pediatric patient with anti-NMDAR encephalitis. A-12-year-old girl presented with abnormal behavior for one week came to Emergency Department of Sarawak General Hospital, Malaysia. She had psychotic spectrum symptoms including suicidal tendency. She was diagnosed with anti-NMDAR encephalitis as positive antibody was seen in her cerebrospinal fluid. She was treated with Injection Immunoglobulin. She turned out to have teratoma which was successfully removed later. Her progress was remarkable after the surgery with the Immunoglobulin. A multi-disciplinary team involving a psychiatrist, neurologist and gynaecologist liaised with intensivist to successfully manage the case and achieve the good outcome.
Relating molecular descriptors to frontier orbital energy levels, singlet and triplet excited states of fused tricyclics using machine learning

Woon KL, Chong ZX, Ariffin A, Chan CS

J Mol Graph Model, 2021 06;105:107891.
PMID: 33765526 DOI: 10.1016/j.jmgm.2021.107891

Fused tricyclic organic compounds are an important class of organic electronic materials. In designing molecules for organic electronics, knowing what chemical structure that be used to tune the molecular property is one of the keys that can help to improve the material performance. In this research, we applied machine learning and data analytic approaches in addressing this problem. The energy states (Lowest Unoccupied Molecular Orbital (HOMO), Highest Occupied Molecular Orbitals (LUMO), singlet (Es) and triplet (ET) energy) of more than 10 thousand fused tricyclics are calculated. Corresponding descriptors are also generated. We find that the Coulomb matrix is a poorer descriptor than high-level descriptors in a multilayer perceptron neural network. Correlations as high as 0.95 is obtained using a multilayer perceptron neural network with Mean Absolute Error as low as 0.08 eV. The descriptors that are important in tuning the energy levels are revealed using the Random Forest algorithm. Correlations of such descriptors are also plotted. We found that the higher the number of tertiary amines, the deeper are the HOMO and LUMO levels. The presence of NN in the aromatic rings can be used to tune the ES. However, there is no single dominant descriptor that can be correlated with the ET. A collection of descriptors is found to give a far better correlation with ET. This research demonstrated that machine learning and data analytics in guiding how certain chemical substructures correlate with the molecule energy states.
An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder

Woon LS, Kanapathy A, Zakaria H, Alfonso CA

Psychodyn Psychiatry, 2017;45(2):237-257.
PMID: 28590207 DOI: 10.1521/pdps.2017.45.2.237

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.
Fulltext Association between insight and internalized stigma and other clinical factors among patients with depression: A cross-sectional study

Woon LS, Khoo SI, Baharudin A, Midin M

Indian J Psychiatry, 2020 03 17;62(2):186-192.
PMID: 32382179 DOI: 10.4103/psychiatry.IndianJPsychiatry_612_19

Background: Insight influences treatment adherence among patients with depression. These patients also experience considerable social and self-stigma. The relationship between insight and internalized stigma has been extensively studied among patients with schizophrenia but not patients with depression.
Aim: This study aimed to determine the relationship between the level of insight in illness and internalized stigma among patients with depression and to identify the clinical factors associated with impaired insight.
Materials and Methods: A cross-sectional survey was conducted among adult psychiatric outpatients with depressive disorders at a teaching hospital in Kuala Lumpur for 10 months. Sociodemographic and illness-related data were gathered. Two questionnaires, Mood Disorder Insight Scale (MDIS) and Internalized Stigma of Mental Illness Scale (ISMI), were administered.
Results: Ninety-nine respondents participated in the study (female: 63.6%; Malay: 41.4%; mean age: 46.4 years). The median duration of illness was 6.0 years. More respondents were taking combination therapy (59.6%). There was a statistically significant correlation between ISMI and MDIS scores (rs = 0.339, P = 0.001). On bivariate analyses, intact insight was associated with non-Malay race, combination therapy, higher average ISMI scores and subscores for alienation, stereotype endorsement, discrimination experience, and social withdrawal. Combination therapy, higher scores for alienation, and social withdrawal subscales were associated with a greater likelihood for intact insight in logistic regression model.
Conclusions: Significant association exists between insight and internalized stigma in patients with depression. Interventions to reduce the impact of internalized stigma while improving patients' insight are required.
Fulltext A Content Review of Life Cycle Assessment of Nanomaterials: Current Practices, Challenges, and Future Prospects

Nizam NUM, Hanafiah MM, Woon KS

Nanomaterials (Basel), 2021 Dec 07;11(12).
PMID: 34947673 DOI: 10.3390/nano11123324

This paper provides a comprehensive review of 71 previous studies on the life cycle assessment (LCA) of nanomaterials (NMs) from 2001 to 2020 (19 years). Although various studies have been carried out to assess the efficiency and potential of wastes for nanotechnology, little attention has been paid to conducting a comprehensive analysis related to the environmental performance and hotspot of NMs, based on LCA methodology. Therefore, this paper highlights and discusses LCA methodology's basis (goal and scope definition, system boundary, life cycle inventory, life cycle impact assessment, and interpretation) to insights into current practices, limitations, progress, and challenges of LCA application NMs. We found that there is still a lack of comprehensive LCA study on the environmental impacts of NMs until end-of-life stages, thereby potentially supporting misleading conclusions, in most of the previous studies reviewed. For a comprehensive evaluation of LCA of NMs, we recommend that future studies should: (1) report more detailed and transparent LCI data within NMs LCA studies; (2) consider the environmental impacts and potential risks of NMs within their whole life cycle; (3) adopt a transparent and prudent characterization model; and (4) include toxicity, uncertainty, and sensitivity assessments to analyze the exposure pathways of NMs further. Future recommendations towards improvement and harmonization of methodological for future research directions were discussed and provided. This study's findings redound to future research in the field of LCA NMs specifically, considering that the release of NMs into the environment is yet to be explored due to limited understanding of the mechanisms and pathways involved.

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