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  1. Acinetobacter baumannii subunit vaccines: recent progress and challenges
    Lau YT, Tan HS
    Crit Rev Microbiol, 2024 Aug;50(4):434-449.
    PMID: 37211625 DOI: 10.1080/1040841X.2023.2215303
    Acinetobacter baumannii is a Gram-negative, opportunistic pathogen that causes nosocomial infection with a high mortality rate in immunocompromised individuals. With the frequent emergence of multidrug-resistant A. baumannii strains that have rapidly gained resistance to most antibiotics, an extensive search for an effective A. baumannii vaccine is ongoing. Over the decade, many subunit vaccine candidates were identified using reverse vaccinology and in vivo animal studies for validation. Nineteen subunit vaccine candidates with a wide range of efficacy, from 14% to 100% preclinical survival rates, were included in this review. This article provides an updated review of several outer membrane proteins (Omp) that emerged as vaccine candidates with great potential, including OmpA, Omp34, Omp22 and BamA, based on their high conservancy, antigenicity, and immune protection against A. baumannii infection. However, there is still no licenced A. baumannii vaccine currently due to several practical issues that have yet to be resolved, such as inconsistencies between validation studies, antigen variability and insolubility. Moving forward, much investigation and innovation are still required to tackle these challenges for the regulatory approval of an A. baumannii subunit vaccine, including standardisation of immunisation study parameters, improving antigen solubility and the incorporation of nucleic acid vaccine technology.
  2. Biosensors for the detection of lung cancer biomarkers: A review on biomarkers, transducing techniques and recent graphene-based implementations
    Lin LP, Tan MTT
    Biosens Bioelectron, 2023 Oct 01;237:115492.
    PMID: 37421797 DOI: 10.1016/j.bios.2023.115492
    Lung cancer remains the leading cause of cancer-related death. In addition to chest X-rays and computerised tomography, the detection of cancer biomarkers serves as an emerging diagnostic tool for lung cancer. This review explores biomarkers including the rat sarcoma gene, the tumour protein 53 gene, the epidermal growth factor receptor, the neuron-specific enolase, the cytokeratin-19 fragment 21-1 and carcinoembryonic antigen as potential indicators of lung cancer. Biosensors, which utilise various transduction techniques, present a promising solution for the detection of lung cancer biomarkers. Therefore, this review also explores the working principles and recent implementations of transducers in the detection of lung cancer biomarkers. The transducing techniques explored include optical techniques, electrochemical techniques and mass-based techniques for detecting biomarkers and cancer-related volatile organic compounds. Graphene has outstanding properties in terms of charge transfer, surface area, thermal conductivity and optical characteristics, on top of allowing easy incorporation of other nanomaterials. Exploiting the collective merits of both graphene and biosensor is an emerging trend, as evidenced by the growing number of studies on graphene-based biosensors for the detection of lung cancer biomarkers. This work provides a comprehensive review of these studies, including information on modification schemes, nanomaterials, amplification strategies, real sample applications, and sensor performance. The paper concludes with a discussion of the challenges and future outlook of lung cancer biosensors, including scalable graphene synthesis, multi-biomarker detection, portability, miniaturisation, financial support, and commercialisation.
  3. MJP going green
    Tan GC, Cheong SK
    Malays J Pathol, 2023 Dec;45(3):315.
    PMID: 38155374
    No abstract available.
  4. Fulltext Impulsivity, Gambling-Related Cognitions, Cognitive Reappraisal and Gambling Behaviour in a Malaysian Sample
    Tan GSL, Tam CL
    J Gambl Stud, 2024 Jun;40(2):475-492.
    PMID: 37544960 DOI: 10.1007/s10899-023-10246-7
    The relationships between cognitive reappraisal and problem gambling have been widely studied in different contexts. However, previous research findings remain inconsistent. This discrepancy might be attributed to the effects of interactions between cognitive reappraisal and other risk factors for problem gambling. Using moderation models, this study examined the association between impulsivity, gambling-related cognitive distortions, cognitive reappraisal and problem gambling in a sample of Malaysian gamblers. A total of 149 community gamblers (103 males, 46 females; mean age = 32.18) completed an online questionnaire. Problem gambling was measured with the South Oaks Gambling Screen (SOGS); cognitive reappraisal was measured using the Emotion Regulation Questionnaire-Cognitive Reappraisal Subscale (ERQ-CR); impulsivity was measured with the Short-UPPS-P Impulsive Behaviour Scale (SUPPS-P); and gambling-related cognitive distortions were measured using the Gambling Related Cognitions Scale (GRCS). The results revealed impulsivity and gambling-related cognitive distortions as significant predictors of problem gambling. At high levels, impulsivity and cognitive distortions are significant moderator variables that strengthen the association between cognitive reappraisal and problem gambling. These findings demonstrate that reappraisal skills could exacerbate problem gambling severity amongst impulsive or self-deceptive gamblers. Future research with larger and more representative samples is needed to validate and generalise these findings.
  5. Integrating augmented reality technology in education: vector personal computer augmented reality
    Tan SY, Tay NNW
    F1000Res, 2021;10:987.
    PMID: 37767360 DOI: 10.12688/f1000research.72948.2
    Background: Educators often face difficulties in explaining abstract concepts such as vectors. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, fully online classes have also caused additional challenges to using conventional teaching methods. To explain a vector concept of more than 2 dimensions, visualization becomes a problem. Although Microsoft PowerPoint can integrate animation, the illustration is still in 2-dimensions. Augmented reality (AR) technology is recommended to aid educators and students in teaching-learning vectors, namely via a vector personal computer augmented reality system (VPCAR), to fulfil the demand for tools to support the learning and teaching of vectors. Methods: A PC learning module for vectors was developed in a 3-dimensional coordinate system by using AR technology. Purposive sampling was applied to get feedback from educators and students in Malaysia through an online survey. The supportiveness of using VPCAR based on six items (attractiveness, easiness, visualization, conceptual understanding, inspiration and helpfulness) was recorded on 5-points Likert-type scales. Findings are presented descriptively and graphically. Results: Surprisingly, both students and educators adapted to the new technology easily and provided significant positive feedback that showed a left-skewed and J-shaped distribution for each measurement item, respectively. The distributions were proven significantly different among the students and educators, where supportive level result of educators was higher than students. This study introduced a PC learning module other than mobile apps as students mostly use laptops to attend online class and educators also engage other IT tools in their teaching. Conclusions: Based on these findings, VPCAR provides a good prospect in supporting educators and students during their online teaching-learning process. However, the findings may not be generalizable to all students and educators in Malaysia as purposive sampling was applied. Further studies may focus on government-funded schools using the newly developed VPCAR system, which is the novelty of this study.
  6. Fulltext Text presentation or video: Malaysian university students' preferences with synchronous and asynchronous learning
    Azar AS, Tan NHI
    Educ Inf Technol (Dordr), 2023 May 04.
    PMID: 37361839 DOI: 10.1007/s10639-023-11796-4
    In overcoming the obstacles of online learning with the current Covid-19 pandemic crisis, synchronous and asynchronous learning has been a significant part of teaching strategies applied by educators to construct a collaborative online environment with Malaysian university students. Synchronous learning has always been the most effective strategy for social learning, while asynchronous learning allows students to learn on their own schedule. Moreover, despite having many educational platforms created for higher educational settings, the practicality of selection between two teaching-learning approaches of text-presentation and video is still a debate among teachers/ lecturers with students' learning styles. Therefore, this paper explored Malaysian university students' preferences between synchronous and asynchronous learning modes with text-presentation or video. Qualitative and quantitative data from 178 participants from both public and private universities were collected via open and close-ended questions in the designed questionnaire. The findings indicated that 68% of the students preferred synchronous learning mode compared to asynchronous. Meanwhile, 39% of the students favoured both text-presentation and video learning tools to be implemented in synchronous and asynchronous approaches as it provided them better opportunities to grasp the learning content better. Thus, it can be concluded that the synchronous learning mode is preferred if only one method is provided as the students highly value the teacher's presence for ease of communication, but students prefer a range of delivery methods. Moreover, the students also displayed a strong preference for applying both text-presentation and video to achieve their learning outcomes. Thus, it is suggested that the university lecturers need to explore and apply interactive pedagogical methods in online teaching-learning process, while contributing to the development of motivation, participation, and engagement among the university students in acquiring their subjects. As such, the findings of this study have informed the pedagogical implications, and further studies are mandatory.
  7. Fulltext The correlations between food security, diet quality and weight change among working women of reproductive age during the endemic phase of COVID-19
    Vicheet WV, Tan ST
    Z Gesundh Wiss, 2023 May 25.
    PMID: 37361309 DOI: 10.1007/s10389-023-01941-1
    AIM: This cross-sectional study aims to investigate the correlations between food security, diet quality and weight change among working women during the endemic phase of COVID-19 in the Klang Valley of Malaysia.

    METHODS: Working women aged 18-49 years were required to self-report their socio-demographics and pre-pandemic body weight (body weight during February 2020). Body height and current body weight were measured using a SECA stadiometer and TANITA weighing scale. Food security was assessed using the Food Insecurity Experience Scale (FIES); the diet quality was determined with the Diet Quality Questionnaire (DQQ) for Malaysia.

    RESULTS: The prevalence of moderate-to-severe food insecurity was 19.9%. It is noted that 64.3% of working women gained weight throughout the pandemic, with an average weight gain of 4.36 ± 3.19 kg. Concerning diet quality, the majority (82.5%) achieved the Minimum Dietary Diversity for Women (MDD-W). Findings from linear regression revealed that food security was not significantly correlated with weight change. However, working women who failed to achieve the MDD-W gained, on average, 1.853 kg more than those who did (p = 0.040). On the other hand, no significant correlation was observed between food security status and diet quality in weight change of working women.

    CONCLUSION: The current study shall provide an impetus to develop intervention strategies for promoting healthy eating among working women.

  8. Case Reports and Movement Disorder Rounds: Learning through observation, building on collective experiences
    Tan AH, Gatto EM
    Parkinsonism Relat Disord, 2023 May;110:105396.
    PMID: 37045676 DOI: 10.1016/j.parkreldis.2023.105396
  9. Prevalence and burden of diabetes mellitus-related symptoms in patients with type 2 diabetes mellitus: A cross-sectional study
    Tan JYH, Ng CJ
    Malays Fam Physician, 2023;18:71.
    PMID: 38213386 DOI: 10.51866/oa.416
    INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a significant non-communicable disease in Malaysia, with a prevalence of 18.1%, per the National Health and Morbidity Survey. This study aimed to determine the prevalence and burden of diabetes mellitus-related symptoms and whether these symptoms were addressed by primary care doctors.

    METHODS: This 1-month cross-sectional study was conducted at an urban hospital-based primary care clinic in Malaysia. Patients with T2DM were recruited using systematic random sampling. Participants answered a self-administered questionnaire adapted from the Diabetes Symptom Checklist-Revised, which evaluated the sociodemographic characteristics, burden of diabetes mellitus-related symptoms in the past month and post-consultation feedback about symptoms. Data were analysed using SPSS.

    RESULTS: Four hundred eighteen participants were included, yielding a response rate of 97.7%. Hyperglycaemia was the most prevalent symptom, with 48.1% of the participants reporting a frequent need to empty their bladder. Most participants experienced a low symptom burden, so 56.7% did not report their symptoms to their doctors. The participants who reported their symptoms had a higher symptom burden. Among them, 97.5% indicated that their doctors addressed their symptoms. Approximately 78% reported satisfaction and good coping skills when their symptoms were addressed.

    CONCLUSION: Hyperglycaemia was the most prevalent diabetes mellitus-related symptom among the patients with T2DM. The symptom burden was generally low, so most patients did not report their symptoms to their doctors. Those who reported their symptoms had a higher symptom burden. Further studies must explore why patients do not report their symptoms and how doctors address patients' symptoms.

  10. Integrating personal and professional development course to undergraduate dental education
    Tan WW, Lin GSS
    J Dent Educ, 2024 Jan 15.
    PMID: 38223980 DOI: 10.1002/jdd.13438
  11. Ageing and the gut-brain axis: lessons from the Drosophila model
    Tan FHP, Shamsuddin S, Zainuddin A
    Benef Microbes, 2023 Dec 13;14(6):591-607.
    PMID: 38350490 DOI: 10.1163/18762891-20230056
    The steady decline of physiological function and increased vulnerability to age-related disorders are two features of the complicated biological process of ageing. As a key organ for nutrient absorption, metabolism, and immunological regulation, the gut plays a major part in the ageing process. Drosophila melanogaster, a well-established model organism, has emerged as a significant tool for exploring the intricate rapport between the gut and ageing. Through the use of Drosophila models, the physiological and molecular elements of the gut-brain axis have been thoroughly explored. These models have also provided insights into the mechanisms by which gut health impacts ageing and age-related illnesses. Drosophila's gut microbiota experience dysbiosis with age which has been linked to age-related diseases. To prevent this and promote healthy ageing in Drosophila, gut microbiota modification methods, such as dietary restriction in tandem with time-restricted feeding, administration of pro-, pre- and synbiotics, as well as pharmaceutical interventions have been generated with positive impacts. The article also covers the drawbacks and difficulties of investigating the gut via the Drosophila. Thus, with an emphasis on the lessons discovered from Drosophila research, this review provides an extensive description of the current studies on the role of the gut-brain axis in ageing and health.
  12. Molecular defense response of oil palm to Ganoderma infection
    Ho CL, Tan YC
    Phytochemistry, 2015 Jun;114:168-77.
    PMID: 25457484 DOI: 10.1016/j.phytochem.2014.10.016
    Basal stem rot (BSR) of oil palm roots is due to the invasion of fungal mycelia of Ganoderma species which spreads to the bole of the stem. In addition to root contact, BSR can also spread by airborne basidiospores. These fungi are able to break down cell wall components including lignin. BSR not only decreases oil yield, it also causes the stands to collapse thus causing severe economic loss to the oil palm industry. The transmission and mode of action of Ganoderma, its interactions with oil palm as a hemibiotroph, and the molecular defence responses of oil palm to the infection of Ganoderma boninense in BSR are reviewed, based on the transcript profiles of infected oil palms. The knowledge gaps that need to be filled in oil palm-Ganoderma molecular interactions i.e. the associations of hypersensitive reaction (HR)-induced cell death and reactive oxygen species (ROS) kinetics to the susceptibility of oil palm to Ganoderma spp., the interactions of phytohormones (salicylate, jasmonate and ethylene) at early and late stages of BSR, and cell wall strengthening through increased production of guaiacyl (G)-type lignin, are also discussed.
  13. In silico approaches for probiotic-derived bioactives
    Tan PL, Liong MT
    Trends Biotechnol, 2014 Dec;32(12):599-601.
    PMID: 25457386 DOI: 10.1016/j.tibtech.2014.09.011
  14. Immobilization of β-glucosidase from Aspergillus niger on κ-carrageenan hybrid matrix and its application on the production of reducing sugar from macroalgae cellulosic residue
    Tan IS, Lee KT
    Bioresour Technol, 2015 May;184:386-94.
    PMID: 25465785 DOI: 10.1016/j.biortech.2014.10.146
    A novel concept for the synthesis of a stable polymer hybrid matrix bead was developed in this study. The beads were further applied for enzyme immobilization to produce stable and active biocatalysts with low enzyme leakage, and high immobilization efficiency, enzyme activity, and recyclability. The immobilization conditions, including PEI concentration, activation time and pH of the PEI solution were investigated and optimized. All formulated beads were characterized for its functionalized groups, composition, surface morphology and thermal stability. Compared with the free β-glucosidase, the immobilized β-glucosidase on the hybrid matrix bead was able to tolerate broader range of pH values and higher reaction temperature up to 60 °C. The immobilized β-glucosidase was then used to hydrolyse pretreated macroalgae cellulosic residue (MCR) for the production of reducing sugar and a hydrolysis yield of 73.4% was obtained. After repeated twelve runs, immobilized β-glucosidase retained about 75% of its initial activity.
  15. Fulltext Chemotherapy extravasation at Hospital Pulau Pinang, Malaysia
    Tan AL, Phua VC
    Med J Malaysia, 2014 Jun;69(3):124-5.
    PMID: 25326352 MyJurnal
    PURPOSE: Extravasation with intravenous chemotherapy is a common complication of chemotherapy which carries the risk of devastating complications. This study aims to determine the rate of extravasation with intravenous chemotherapy in a major hospital where chemotherapy is delivered in various departments other than the oncology department.

    PATIENTS AND METHODS: All patients who underwent intravenous chemotherapy in the oncology department and surgical wards in Penang General hospital from 1st February 2008 till 31st June 2008 were recruited retrospectively for this study to look at the rate of extravasation.

    RESULTS: A total of 602 patients underwent intravenous chemotherapy during this period. Fifty patients received chemotherapy in the general surgical ward while another 552 patients received chemotherapy in the oncology department. There were 5 cases of extravasation giving an overall extravasation rate of 0.8% (5/602). however, 4 of these cases occurred in the general surgical ward giving it a rate of 8% (4/50).

    CONCLUSION: The rate of extravasation in our hospital was 0.8%. however, this rate can be significantly increased if it is not done under a specialized unit delivering intravenous chemotherapy on a regular basis. Preventive steps including a standard chemotherapy delivery protocol, staff and patient education must be put in place in all units delivering intravenous chemotherapy.
  16. Fulltext Impact of atrial fibrillation among stroke patients in a Malaysian teaching hospital
    Chee KH, Tan KS
    Med J Malaysia, 2014 Jun;69(3):119-23.
    PMID: 25326351 MyJurnal
    OBJECTIVES: Atrial fibrillation (AF) is a well-recognised, major risk factor for ischaemic stroke. The presence of atrial fibrillation in a stroke patient translates into higher mortality rates and significant disability. There is lack of data on the impact of atrial fibrillation on stroke patients in Malaysia. The aim of this study was to determine the prevalence of AF in a hospital setting and determine the risk factors, clinical profile and discharge outcomes in ischaemic stroke patients with and without atrial fibrillation from a tertiary centre in Malaysia.
    METHODS: This was a retrospective review of patients admitted consecutively to the University Malaya Medical Centre, Kuala Lumpur with the diagnosis of stroke during the first six months of 2009. The presence of AF was confirmed with a 12- lead ECG. All patients had neuroimaging with either cranial computed tomography (CT) or magnetic resonance imaging (MRI). Other variables such as clinical features, risk factors, stroke subtypes, length of acute ward stay, complications and evaluation at discharge (mortality) with modified Rankin scale (mRS) were also recorded.
    RESULTS: A total of 207 patients were admitted with stroke during the study duration. Twenty two patients (10.6%) were found to have non valvular AF. Patients with AF were found to be older with a mean age of 71.0 ± 2.2 than those without AF with a mean age of 63.6 ± 0.89 (p<0.05). Risk factors for stroke such as diabetes mellitus and hypertension were equally common between the two groups while the proportion of patients with ischaemic heart disease was higher among patients with AF (p<0.005). Most of the stroke subtypes among patients with AF were of ischaemic type (n=192; 92.8%) while haemorrhagic stroke was uncommon (n=15; 6.2%). Patients with AF had a longer median hospital stay, higher mortality rate and greater functional disability on hospital discharge compared to non AF patients.
    CONCLUSION: The prevalence of AF among stroke patients in a tertiary centre in Malaysia was 10.6%. Stroke patients with AF were observed to have a higher mortality rate and disability on hospital discharge.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  17. Fulltext Phage display creates innovative applications to combat hepatitis B virus
    Tan WS, Ho KL
    World J Gastroenterol, 2014 Sep 7;20(33):11650-70.
    PMID: 25206271 DOI: 10.3748/wjg.v20.i33.11650
    Hepatitis B virus (HBV) has killed countless lives in human history. The invention of HBV vaccines in the 20(th) century has reduced significantly the rate of the viral infection. However, currently there is no effective treatment for chronic HBV carriers. Newly emerging vaccine escape mutants and drug resistant strains have complicated the viral eradication program. The entire world is now facing a new threat of HBV and human immunodeficiency virus co-infection. Could phage display provide solutions to these life-threatening problems? This article reviews critically and comprehensively the innovative and potential applications of phage display in the development of vaccines, therapeutic agents, diagnostic reagents, as well as gene and drug delivery systems to combat HBV. The application of phage display in epitope mapping of HBV antigens is also discussed in detail. Although this review mainly focuses on HBV, the innovative applications of phage display could also be extended to other infectious diseases.
  18. Fulltext False Negative (99m)Tc-Hydroxymethane Diphosphonate Three-phase Bone Scintigraphy and (99m)Tc-besilesomab Scan in Detecting Tibia Osteomyelitis Concomitant with Necrotizing Fasciitis
    Tan TH, Lee BN
    World J Nucl Med, 2014 Sep;13(3):190-2.
    PMID: 25538491 DOI: 10.4103/1450-1147.144820
    We described a case of 51-year-old female patient presented with a right calf necrotising fasciitis (NF) where osteomyelitis (OM) was suspected. (99m)Tc-hydroxymethane diphosphonate three-phase bone scintigraphy and (99m)Tc-besilosomab scan failed to demonstrate classical features of OM. The final diagnosis was only made by isolating Acinetobacter sp. in both intra-operative bone and tissue cultures from below-knee amputation. As conclusions, the detection of lower limb OM by (99m)Tc-besilosomab scan is not easy when there is concurrence overlying NF. The unusual three-phase bone scan finding of pericortical accumulation of tracer as an early sign of OM is highlighted in this case.
  19. Critical analysis of current methods for assessing the in vitro antioxidant and antibacterial activity of plant extracts
    Tan JB, Lim YY
    Food Chem, 2015 Apr 1;172:814-22.
    PMID: 25442625 DOI: 10.1016/j.foodchem.2014.09.141
    Natural product research is an active branch of science, driven by the increased value placed on individual health and well-being. Many naturally-occurring phytochemicals in plants, fruits and vegetables have been reported to exhibit antioxidant and antibacterial activity; often touted as being beneficial for human health. In vitro screening is a common practice in many research laboratories as a means of rapidly assessing these properties. However, the methods used by many are not necessarily optimal; a result of poor standardization, redundant assays and/or outdated methodology. This review primarily aims to give a better understanding in the selection of in vitro assays, with emphasis placed on some common assays such as the total phenolic content assay, free radical scavenging activity, disc-diffusion and broth microdilution. This includes a discussion on the reasons for choosing a particular assay, its strengths and weaknesses, ways to improve the accuracy of results and alternative assays.
  20. The effects of Andrographis paniculata (Burm.f.) Nees extract and diterpenoids on the CYP450 isoforms' activities, a review of possible herb-drug interaction risks
    Tan ML, Lim LE
    Drug Chem Toxicol, 2015;38(3):241-53.
    PMID: 25156015 DOI: 10.3109/01480545.2014.947504
    Andrographis paniculata (Burm.f.) Nees is a popular medicinal plant and its components are used in various traditional product preparations. However, its herb-drug interactions risks remain unclear. This review specifically discusses the various published studies carried out to evaluate the effects of Andrographis paniculata (Burm.f.) Nees plant extracts and diterpenoids on the CYP450 metabolic enzyme and if the plant components pose a possible herb-drug interaction risk. Unfortunately, the current data are insufficient to indicate if the extracts or diterpenoids can be labeled as in vitro CYP1A2, CYP2C9 or CYP3A4 inhibitors. A complete CYP inhibition assay utilizing human liver microsomes and the derivation of relevant parameters to predict herb-drug interaction risks may be necessary for these isoforms. However, based on the current studies, none of the extracts and diterpenoids exhibited CYP450 induction activity in human hepatocytes or human-derived cell lines. It is crucial that a well-defined experimental design is needed to make a meaningful herb-drug interaction prediction.
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