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Displaying publications 6821 - 6840 of 8505 in total

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Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals

Elhaj FA, Salim N, Harris AR, Swee TT, Ahmed T

Comput Methods Programs Biomed, 2016 Apr;127:52-63.
PMID: 27000289 DOI: 10.1016/j.cmpb.2015.12.024

Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support vector machine and radial basis function method.
In vivo proton magnetic resonance spectroscopy (1H-MRS) evaluation of the metabolite concentration of optic radiation in primary open angle glaucoma

Sidek S, Ramli N, Rahmat K, Ramli NM, Abdulrahman F, Kuo TL

Eur Radiol, 2016 Dec;26(12):4404-4412.
PMID: 26943134

OBJECTIVE: To compare the metabolite concentration of optic radiation in glaucoma patients with that of healthy subjects using Proton Magnetic Resonance Spectroscopy (1H-MRS).
METHODS: 1H-MRS utilising the Single-Voxel Spectroscopy (SVS) technique was performed using a 3.0Tesla MRI on 45 optic radiations (15 from healthy subjects, 15 from mild glaucoma patients, and 15 from severe glaucoma patients). A standardised Volume of Interest (VOI) of 20 × 20 × 20 mm was placed in the region of optic radiation. Mild and severe glaucoma patients were categorised based on the Hodapp-Parrish-Anderson (HPA) classification. Mean and multiple group comparisons for metabolite concentration and metabolite concentration ratio between glaucoma grades and healthy subjects were obtained using one-way ANOVA.
RESULTS: The metabolite concentration and metabolite concentration ratio between the optic radiations of glaucoma patients and healthy subjects did not demonstrate any significant difference (p > 0.05).
CONCLUSION: Our findings show no significant alteration of metabolite concentration associated with neurodegeneration that could be measured by single-voxel 1H-MRS in optic radiation among glaucoma patients.
KEY POINTS: • Glaucoma disease has a neurodegenerative component. • Metabolite changes have been observed in the neurodegenerative process in the brain. • Using SVS, no metabolite changes in optic radiation were attributed to glaucoma.
Evaluation of a Colorectal Carcinoma Screening Program in Kota Setar and Kuala Muda Districts, Malaysia

Abu Hassan MR, Leong TW, Othman Andu DF, Hat H, Nik Mustapha NR

Asian Pac J Cancer Prev, 2016;17(2):569-73.
PMID: 26925645

BACKGROUND: A colorectal cancer screening program was piloted in two districts of Kedah in 2013. There is scarcity of information on colorectal cancer screening in Malaysia.
OBJECTIVE: Thus, this research was conducted to evaluate the colorectal cancer screening program in the districts to provide insights intop its efficacy.
MATERIALS AND METHODS: A cross sectional study was conducted using data on the colorectal cancer screening program in 2013 involving Kota Setar and Kuala Muda districts in Malaysia. We determined the response rate of immunochemical fecal occult blood test (iFOBT), colonoscopy compliance, and detection rates of neoplasia and carcinoma. We also compared the response of FOBT by demographic background.
RESULTS: The response rate of FOBT for first iFOBT screening was 94.7% while the second iFOBT screening was 90.7%. Participants from Kuala Muda district were 27 times more likely to default while Indians had a 3 times higher risk of default compared to Malays. The colonoscopy compliance was suboptimal among those with positive iFOBT. The most common finding from colonoscopy was hemorrhoids, followed by tubular adenoma. Detection rate of carcinoma and neoplasia for our program was 1.2%.
CONCLUSIONS: In summary, the response rate of iFOBT was encouraging but the colonoscopy compliance was suboptimal which led to a considerably low detection rate.
Symptom Prevalence and Related Distress in Cancer Patients Undergoing Chemotherapy

Thiagarajan M, Chan CM, Fuang HG, Beng TS, Atiliyana MA, Yahaya NA

Asian Pac J Cancer Prev, 2016;17(1):171-6.
PMID: 26838205

BACKGROUND: Much has been done to examine the psychological impact of cancer treatment, but it remains unclear to what extent anxiety and depression is related to symptom prevalence. The present study concerned the characteristics and frequency of distress as related to symptom prevalence in cancer patients undergoing chemotherapy in Malaysia.
MATERIALS AND METHODS: Participants were 303 consecutive adult cancer patients undergoing chemotherapy in an academic medical center. The short form Memorial Symptom Assessment Scale (MSAS-SF), which covers three domains of symptoms (global distress, physical- and psychological symptoms) was used to cross-sectionally measure symptom frequency and associated distress via self-reporting. One-way ANOVA and t-tests were used to test mean differences among MSAS-SF subscale scores.
RESULTS: Complete data were available for 303 patients. The mean number of symptoms was 14.5. The five most prevalent were fatigue, dry mouth, hair loss, drowsiness and lack of appetite. Overall, symptom burden and frequency were higher than in other published MSAS-SF studies. Higher symptom frequency was also found to be significantly related to greater distress in cancer patients undergoing chemotherapy.
CONCLUSIONS: Patients undergoing chemotherapy suffer from multiple physical and psychological symptoms. Better symptom control or palliative care is needed. Greater frequency of reported symptoms may also indicate a subconscious bid by patients for care and reassurance - thus tailored intervention to manage distress should be offered.
Report: Demographic profiles and sleep quality among patients on methadone maintenance therapy (MMT) in Malaysia

Zahari Z, Siong LC, Musa N, Mohd Yasin MA, Choon TS, Mohamad N, et al.

Pak J Pharm Sci, 2016 Jan;29(1):239-46.
PMID: 26826835

Poor sleep quality was frequently reported by opioid dependence patients during methadone maintenance therapy (MMT). The study investigated a sample of patients on MMT to investigate the severity and prevalence of sleep problems in MMT patients. We evaluated sleep quality and disturbances of 119 Malay male patients from MMT clinics in Kelantan, Malaysia between March and July 2013 using the Pittsburgh Sleep Quality Index (PSQI)-Malay version. Patients' demographic, clinical data, past drug history and methadone treatment variables were recorded. Patients averaged 37.5 years of age (SD 6.79) and their mean age of first time illicit drug use was 19.3 years (SD 4.48). Their mean age of entering MMT was 34.7 years (SD 6.92) and the mean duration in MMT was 2.8 years (SD 2.13). The mean current daily dosage of methadone was 77.8 mg (SD 39.47) and ranged from 20 to 360 mg. The mean global PSQI score was 5.6 (SD 2.79) and 43.7% patients were identified as 'poor sleepers' (global PSQI scores >5). This study confirms the poor overall sleep quality among patients on MMT. The prevalence and severity of sleep problems in MMT patients should not be underestimated.
Fulltext A Cell Internalizing Antibody Targeting Capsid Protein (p24) Inhibits the Replication of HIV-1 in T Cells Lines and PBMCs: A Proof of Concept Study

Ali SA, Teow SY, Omar TC, Khoo AS, Choon TS, Yusoff NM

PLoS One, 2016;11(1):e0145986.
PMID: 26741963 DOI: 10.1371/journal.pone.0145986

There remains a need for newer therapeutic approaches to combat HIV/AIDS. Viral capsid protein p24 plays important roles in HIV pathogenesis. Peptides and small molecule inhibitors targeting p24 have shown to inhibit virus replication in treated cell. High specificity and biological stability of monoclonal antibodies (mAbs) make them an attractive contender for in vivo treatments. However, mAbs do not enter into cells, thus are restricted to target surface molecules. This also makes targeting intracellular HIV-1 p24 a challenge. A mAb specific to p24 that can internalize into the HIV-infected cells is hypothesized to inhibit the virus replication. We selected a mAb that has previously shown to inhibit p24 polymerization in an in vitro assay and chemically conjugated it with cell penetrating peptides (CPP) to generate cell internalizing anti-p24 mAbs. Out of 8 CPPs tested, κFGF-MTS -conjugated mAbs internalized T cells most efficiently. At nontoxic concentration, the κFGF-MTS-anti-p24-mAbs reduced the HIV-1 replication up to 73 and 49% in T-lymphocyte and PBMCs respectively. Marked inhibition of HIV-1 replication in relevant cells by κFGF-MTS-anti-p24-mAbs represents a viable strategy to target HIV proteins present inside the cells.
Fulltext Postauricular neurofibroma - a rare occurrence

Shi Nee T, Ami M, Min Han K, Sabir Husin Athar PP

Braz J Otorhinolaryngol, 2015 12 19;83(5):600-601.
PMID: 26777080 DOI: 10.1016/j.bjorl.2015.09.001
Fulltext Multiracial Facial Golden Ratio and Evaluation of Facial Appearance

Alam MK, Mohd Noor NF, Basri R, Yew TF, Wen TH

PLoS One, 2015;10(11):e0142914.
PMID: 26562655 DOI: 10.1371/journal.pone.0142914

This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18-25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05) but no significant difference was found between races. Out of the 286 subjects, 49 (17.1%) were of ideal facial shape, 156 (54.5%) short and 81 (28.3%) long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts.
High allele frequency of CYP2C9*3 (rs1057910) in a Negrito's subtribe population in Malaysia; Aboriginal people of Jahai

Rosdi RA, Mohd Yusoff N, Ismail R, Soo Choon T, Saleem M, Musa N, et al.

Ann Hum Biol, 2015 Sep 24.
PMID: 26402341

CYP2C9 gene polymorphisms modulate inter-individual variations in the human body's responses to various endogenous and exogenous drug substrates. To date, little is known about the CYP2C9 gene polymorphisms among the aboriginal populations of the world, including those in Malaysia.
Fulltext Blastocystis sp. in Irritable Bowel Syndrome (IBS)--Detection in Stool Aspirates during Colonoscopy

Ragavan ND, Kumar S, Chye TT, Mahadeva S, Shiaw-Hooi H

PLoS One, 2015;10(9):e0121173.
PMID: 26375823 DOI: 10.1371/journal.pone.0121173

Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. Its' association with IBS is controversial, possibly as a result of irregular shedding of parasites in stool and variation in stool detection. We aimed to screen for Blastocystis in colonic stool aspirate samples in adult patients with and without IBS undergoing colonoscopy for various indications and measure the interleukin levels (IL-8, IL-3 and IL-5). In addition to standard stool culture techniques, polymerase chain reaction (PCR) techniques were employed to detect and subtype Blastocystis. All the serum samples collected were subjected for ELISA studies to measure the interleukin levels (IL-8, IL-3 and IL-5). Among 109 (IBS n = 35 and non-IBS n = 74) adults, direct stool examination and culture of colonic aspirates were initially negative for Blastocystis. However, PCR analysis detected Blastocystis in 6 (17%) IBS and 4 (5.5%) non-IBS patients. In the six positive IBS patients by PCR method, subtype 3 was shown to be the most predominant (3/6: 50%) followed by subtype 4 (2/6; 33.3%) and subtype 5 (1/6; 16.6%). IL-8 levels were significantly elevated in the IBS Blasto group and IBS group (p<0.05) compared to non-IBS and non-IBS Blasto group. The level of IL-3 in were seen to be significantly higher in than IBS Blasto group and IBS group (p<0.05) compared to non-IBS. Meanwhile, the IL-5 levels were significantly higher in IBS Blasto group (p<0.05) compared to non-IBS and non-IBS Blasto group. This study implicates that detecting Blastosystis by PCR method using colonic aspirate samples during colonoscopy, suggests that this may be a better method for sample collection due to the parasite's irregular shedding in Blastocystis-infected stools. Patients with IBS infected with parasite showed an increase in the interleukin levels demonstrate that Blastocystis does have an effect in the immune system.
Satisfaction with and Perception of Pain Management among Palliative Patients with Breakthrough Pain: A Qualitative Study

Pathmawathi S, Beng TS, Li LM, Rosli R, Sharwend S, Kavitha RR, et al.

Pain Manag Nurs, 2015 Aug;16(4):552-60.
PMID: 26256219 DOI: 10.1016/j.pmn.2014.10.002

Breakthrough pain is a significant contributor to much suffering by patients. The experience of intense pain may interfere with, and affect, daily life functioning and has major consequences on patients' well-being if it is not well managed. The area of breakthrough pain has not been fully understood. This study thus aimed to explore the experiences of breakthrough pain among palliative patients. A qualitative study based on a series of open-ended interviews among 21 palliative patients suffering from pain at an urban tertiary hospital in Malaysia was conducted. Five themes were generated: (i) pain viewed as an unbearable experience causing misery in the lives of patients, (ii) deterioration of body function and no hope of recovery, (iii) receiving of inadequate pain management for pain, (iv) insensitivity of healthcare providers toward patients' pain experience, and (v) pain coping experiences of patients. The findings revealed that nonpharmacologic approaches such as psychosocial support should be introduced to the patients. Proper guidance and information should be given to healthcare providers to improve the quality of patient care. Healthcare providers should adopt a sensitive approach in caring for patients' needs. The aim is to meet the needs of the patients who want to be pain free or to attain adequate relief of their pain for breakthrough pain.
Fulltext Compact Wideband Four-Port MIMO Antenna for Sub-6 GHz and Internet of Things Applications

Sheriff N, Kamal S, Tariq Chattha H, Kim Geok T, Khawaja BA

Micromachines (Basel), 2022 Dec 12;13(12).
PMID: 36557501 DOI: 10.3390/mi13122202

A compact four-port multi-input, multi-output (MIMO) antenna with good isolation is proposed for sub-6 GHz and Internet of Things (IoT) applications. Four similar L-shaped antennae are placed orthogonally at 7.6 mm distance from the corner of the FR4 substrate. The wideband characteristics and the required frequency band are achieved through the L-shaped structure and with proper placement of the slots on the substrate. To obtain good isolation between the ports, rectangular slots are etched in the bottom layer and are interconnected. The proposed antenna has total dimensions of 40 mm × 40 mm × 1.6 mm. The interconnected ground plane provides good isolation of less than -17 dB between the ports, and the impedance bandwidth obtained by the proposed four-port antenna is about 54% between the frequency range of 3.2 GHz to 5.6 GHz, thus providing a wideband antenna characteristic covering sub-6 GHz 5G bands (from 3.4 to 3.6 GHz and 4.8 to 5 GHz) and the WLAN band (5.2 GHz). The proposed design antenna is fabricated and tested. Good experimental results are achieved when compared with the simulation results. As the proposed design is compact and low profile, this antenna could be a suitable candidate for 5G and IoT devices.
Fulltext Occurrence and Distribution of Antibiotics in the Water, Sediment, and Biota of Freshwater and Marine Environments: A Review

Maghsodian Z, Sanati AM, Mashifana T, Sillanpää M, Feng S, Nhat T, et al.

Antibiotics (Basel), 2022 Oct 23;11(11).
PMID: 36358116 DOI: 10.3390/antibiotics11111461

Antibiotics, as pollutants of emerging concern, can enter marine environments, rivers, and lakes and endanger ecology and human health. The purpose of this study was to review the studies conducted on the presence of antibiotics in water, sediments, and organisms in aquatic environments (i.e., seas, rivers, and lakes). Most of the reviewed studies were conducted in 2018 (15%) and 2014 (11%). Antibiotics were reported in aqueous media at a concentration of <1 ng/L−100 μg/L. The results showed that the highest number of works were conducted in the Asian continent (seas: 74%, rivers: 78%, lakes: 87%, living organisms: 100%). The highest concentration of antibiotics in water and sea sediments, with a frequency of 49%, was related to fluoroquinolones. According to the results, the highest amounts of antibiotics in water and sediment were reported as 460 ng/L and 406 ng/g, respectively. In rivers, sulfonamides had the highest abundance (30%). Fluoroquinolones (with an abundance of 34%) had the highest concentration in lakes. Moreover, the highest concentration of fluoroquinolones in living organisms was reported at 68,000 ng/g, with a frequency of 39%. According to the obtained results, it can be concluded that sulfonamides and fluoroquinolones are among the most dangerous antibiotics due to their high concentrations in the environment. This review provides timely information regarding the presence of antibiotics in different aquatic environments, which can be helpful for estimating ecological risks, contamination levels, and their management.
Evaluation of membrane fouling at elevated temperature impacted by algal organic matter

Ng YS, Ragupathy S, Shau Hwai AT, Khoo KS, Chieh Chan DJ

Chemosphere, 2023 Jan;310:136790.
PMID: 36220430 DOI: 10.1016/j.chemosphere.2022.136790

Membrane distillation (MD) is a thermally driven technology applied in desalination and water reuse with utilisation of sustainable energy. However, algal organic matter (AOM) could foul membrane critically and plague MD's long-term operational stability. In this study, the soluble extracellular polymeric substance (sEPS) and intracellular organic matter with bound extracellular polymeric substance (IOM + bEPS) of two algal species (Amphora coffeaeformis and Navicula incerta) were exposed to 60 °C, 70 °C and 80 °C for 8 h with polypropylene hydrophobic membrane, simulating heated AOMs contacted with membrane inside MD unit, to study the temperature effect on membrane fouling. The dissolved carbohydrate and protein in the sEPS and IOM + bEPS samples generally increased after being heated. Heating caused cell lysis and the release and dissolution of carbohydrate and protein from sEPS, IOM and bEPS into water. As heating temperature increased, the carbohydrate release from the AOM usually increased. The contact angle of membrane contacted with sEPS and IOM + bEPS reduced significantly after heat treatment. The reduction in IOM + bEPS was larger than sEPS, in line with SEM analysis, indicating membrane surfaces and pores with IOM + bEPS fouled more severely than sEPS. It is due to higher hydrophobicity in IOM + bEPS causing adherence to membrane and presence of amphiphiles. High protein, lipid, and saturated fats proportions also cause severe fouling. SEM-EDX analysis indicated presence of O, Na, Cl and Mg elements, pointing to carbohydrate and lipids, and salt trapped in foulants. AOM heating and composition had direct effect to the membrane integrity, dictating severity of fouling in MD operations.
Fulltext Protease-targeting peptide-functionalized porous silicon nanoparticles for cancer fluorescence imaging

Kanathasan JS, Palanisamy UD, Radhakrishnan AK, Chakravarthi S, Thong TB, Swamy V

Nanomedicine (Lond), 2022 Sep;17(21):1511-1528.
PMID: 36382634 DOI: 10.2217/nnm-2022-0017

Background: Porous silicon (pSi) nanoparticles (NPs) functionalized with suitable targeting ligands are now established cancer bioimaging agents and drug-delivery platforms. With growing interest in peptides as tumor-targeting ligands, much work has focused on the use of various peptides in combination with pSi NPs for cancer theranostics. Here, the authors investigated the targeting potential of pSi NPs functionalized with two types of peptide, a linear 10-mer peptide and its branched (Y-shaped) equivalent, that respond to legumain activity in tumor cells. Results: In vitro experiments established that the linear peptide-pSi NP conjugate had better aqueous stability under tumor conditions and higher binding efficiency (p 0.05) of linear peptide-conjugated pSi NPs in the tumor site within 4 h compared with nonconjugated pSi NPs. These results suggest that the linear peptide-pSi NP formulation is a nontoxic, stable and efficient fluorescence bioimaging agent and potential drug-delivery platform.
Fulltext First Report of Athelia rolfsii Causing Damping-Off and Leaf Blight on Basella alba in Malaysia

Khoo YW, Baadu R, Hui Teng T, Khaw YS, Li S, Chong KP

Plant Dis, 2022 Dec 12.
PMID: 36510434 DOI: 10.1094/PDIS-10-21-2266-PDN

Basella alba is an evergreen perennial vine that grows as an edible leafy vegetable in Malaysia (Nordin et al. 2007). During January 2021, a cottony white hypha associated with aggregates of white to brown sclerotia and symptoms of damping-off were visualized on the stem base of B. alba at the soil surface in an isolated field (~0.03 ha) located in the district of Penampang, Sabah province, Malaysia (5°56'51.0"N 116°04'31.8"E). Yellowing and wilting of leaves, and defoliation were observed after four days of the development of damping-off. Survey was conducted on 100 plants which 30 were found infected. The disease severity (90%) on stems was estimated using IMAGEJ. Symptomatic stem tissues were surface sterilized with 75% of ethanol for 1 min, washed with 2% of sodium hypochlorite solution for 1 min, rinsed thrice with sterile distilled water, air dried and plated on potato dextrose agar (PDA). Plates were incubated for 7 days at 25°C in the dark. After 7 days, fungi were isolated; colony color was white and had a cottony appearance. On day 14, white to brown sclerotia 1.0 to 2.2 mm in diameter were produced. Hyaline septate hyphae with clamp connections and multiple nuclei were seen. Conidia and conidiophores were absent from the colony on PDA. Genomic DNA of fungi was extracted based on Khoo et al. (2022a and 2022b). PCR amplification (Khoo et al. 2022b) was performed using primer set ITS1/ITS4, EF983/EF2218 and LR0R/LR05 to amplify the internal transcribed spacer (ITS) region of rDNA, partial translation elongation factor 1 alpha (TEF-1α) gene and partial large subunit ribosomal RNA (LSU rRNA) gene, respectively (Vilgalys and Hester 1990; White et al. 1990; Carbone and Kohn, 1999; Rehner 2001). Phylogenetic analysis indicated that the isolates formed a supported clade to the related Athelia rolfsii sequences. The sequencing result (GenBank Accession Nos. OK465460, OP809607, OP857217) had a 99% identity over 625 bp, 941 bp, and 1,101 bp with the corresponding gene sequence of A. rolfsii (GenBank Accession Nos. MN622806, AY635773, MW322687) after analysis in BLASTn program. Pathogenicity test was performed based on Le (2011). Three 8-week-old B. alba plants cultivated on sterilized soil were inoculated with 5-mm mycelia plugs from 7-day-old culture. A plug was put on the upper soil surface layer 2 cm away from the base of the stem of B. alba plant before fully covered with a layer of sterilized soil. Plants that were inoculated with sterile PDA plugs served as the control treatment. Plastic bags were used to cover the plants after inoculation for 24 h before keeping them in a glasshouse under ambient conditions. Water-soaked and brown lesions were visualized on the stem base of all inoculated plants after four days of inoculation. Symptom of damping-off and leaf blight was observed after another 3 days. No symptoms developed on the mock controls. The pathogenicity test was repeated twice. Re-isolation was performed from the symptomatic tissues of inoculated plants and mock controls. The isolates reisolated from the symptomatic tissues were verified as A. rolfsii based on morphology and molecular characterization, thus fulfilling Koch's postulates. No pathogens were isolated from the mock controls. To our knowledge, this is the first report of A. rolfsii causing damping-off and leaf blight on B. alba in Malaysia, as well as worldwide. Our findings documented the wider geographical and host range of A. rolfsii and indicate its potential threat to B. alba production in Malaysia.
Bisphenol A is a carcinogen that induces lipid accumulation, peroxisome proliferator‑activated receptor‑γ expression and liver disease

Ismael LQ, Abdulhameed AR, Keong YY, Abdullah MNH, Bahari H, Jie TJ, et al.

Exp Ther Med, 2022 Dec;24(6):735.
PMID: 36466761 DOI: 10.3892/etm.2022.11671

Bisphenol (BP) A is an exogenous endocrine disruptor that mimics hormones closely associated with health complications, e.g., obesity and cancers. The present study aimed to evaluate the effects of BPA on human liver cells and tissue. The peroxisome proliferator-activated receptor (PPAR)-γ expression profile across tumour samples and paired normal tissue was first analysed using GEPIA. Subsequently, BPA-treated liver THLE-2 cell viability was evaluated using an MTT assay. Clusterin, PPARα and PPARγ gene expression in BPA-treated THLE-2 cells was assessed using GEPIA before validating the gene expression using real-time PCR and analysing overall survival using TCGA data in GEPIA. Cytoplasmic lipid accumulation was examined in BPA-treated THLE-2 cells using Oil Red O staining, and liver tissue was examined using haematoxylin and eosin staining. Finally, cytochrome P450 (CYP) gene expression was assessed in BPA-treated THLE-2 cells using real-time PCR. PPARγ is likely the primary nuclear receptor protein involved in lipid accumulation in THLE-2 cells following BPA treatment and is associated with liver disease. THLE-2 cells exposed to BPA showed a decrease in viability and lipid accumulation after 48 h treatment. Higher PPARγ gene expression was significantly associated with survival of patients with liver cancer, with an average survival time of <80 months. Haematoxylin and eosin-stained sections showed notable disruption of the liver architecture in tissue exposed to BPA. Downregulated CYP1A1 and CYP1B1 gene expression implied that BPA-treated THLE-2 cells decreased capacity for carcinogen metabolism, while upregulated CYP2S1 gene expression exerted minimal cytotoxicity. The present study revealed that BPA served as a carcinogen, enhanced tumorigenesis susceptibility and may induce other types of liver disease.
Fulltext Retrospective Analysis of Clinical Outcomes of Stereotactic Body Radiation Therapy for Localized Prostate Cancer at an Asian Cancer Specialist Centre

Pei Yuin JL, Jia Shin JT, Jing CB, Mun TL, Balasubramaniam MA, Ibrahim Wahid DM

Asian Pac J Cancer Prev, 2023 Feb 01;24(2):545-550.
PMID: 36853303 DOI: 10.31557/APJCP.2023.24.2.545

INTRODUCTION: The current treatment options for localized prostate cancer are radical prostatectomy and external beam radiotherapy (EBRT) with stereotactic body radiation therapy (SBRT) gaining interest as a treatment option compared to standard fractionation radiation therapy. This present study is a retrospective study evaluating the correlations between the biochemical efficacy, and treatment toxicity in SBRT for localized prostate cancer.
METHODS: All organ-confined prostate cancer patients treated with SBRT from 2010 to 2018, at Beacon Hospital, Malaysia were included in this study. Patient demographics, dosimetric parameters, and disease information were retrospectively collected. The primary endpoint was biochemical recurrence-free survival assessed using the Phoenix definition (Nadir + 2 ng/mL). Toxicity outcomes were scored using the Radiation Therapy Oncology Group scale.
RESULTS: Fourty-nine patients who met the inclusion criteria (5 low-, 13 intermediate- and 31 high-risk according to the D'amico Risk Classification) received SBRT. The most common dose regime was 34-35Gy in 5 fractions (n=18). Other dose regimes were 24Gy in 3 fractions and 25-33Gy in 5 fractions. Median follow-up was 45.4 months. The median pre-treatment prostate-specific antigen (PSA) was 11.22 ng/mL, which decreased to a median PSA of 0.1 ng/mL by 2 years post-treatment. Out of the 49 cases, only 1 case of biochemical recurrence occurred, yielding a 3- and 5-year overall survival of 100%, and a 3- and 5- year biochemical recurrence-free rate of 100% and 95.2%. Acute grade III urinary toxicities occurred in 1 (2%); whereas acute grade I urinary and rectal toxicities were seen in 22 (44.9%) and 7 (14.3%) patients respectively. Grade I and grade III late rectal toxicities occurred in 3 and 1 patients respectively, while 3 and 1 patient reported late grade I and III urethral stricture respectively.
CONCLUSION: SBRT for clinically-localized and locally advanced prostate cancer provided promising outcomes with low toxicity and good biochemical control.
Fulltext Emerging Experiences with Virtual Clinical Ethics Consultation: Case Studies from the United States and Malaysia

Mubarak E, Kaur S, Min MTK, Hughes MT, Rushton CH, Ali J

J Clin Ethics, 2023;34(1):51-57.
PMID: 36940355 DOI: 10.1086/723317

AbstractThe COVID-19 pandemic has inspired numerous opportunities for telehealth implementation to meet diverse healthcare needs, including the use of virtual communication platforms to facilitate the growth of and access to clinical ethics consultation (CEC) services across the globe. Here we discuss the conceptualization and implementation of two different virtual CEC services that arose during the COVID-19 pandemic: the Clinical Ethics Malaysia COVID-19 Consultation Service and the Johns Hopkins Hospital Ethics Committee and Consultation Service. A common strength experienced by both platforms during virtual delivery included improved ability for local practitioners to address consultation needs for patient populations otherwise unable to access CEC services in their respective locations. Additionally, virtual platforms allowed for enhanced collaboration and sharing of expertise among ethics consultants. Both contexts encountered numerous challenges related to patient care delivery during the pandemic. The use of virtual technologies resulted in decreased personalization of patient-provider communication. We discuss these challenges with respect to contextual differences specific to each service and setting, including differences in CEC needs, sociocultural norms, resource availability, populations served, consultation service visibility, healthcare infrastructure, and funding disparities. Through lessons learned from a health system in the United States and a national service in Malaysia, we provide key recommendations for health practitioners and clinical ethics consultants to leverage virtual communication platforms to mitigate existing inequities in patient care delivery and increase capacity for CEC globally.
Fulltext Classification of Atypical White Blood Cells in Acute Myeloid Leukemia Using a Two-Stage Hybrid Model Based on Deep Convolutional Autoencoder and Deep Convolutional Neural Network

Elhassan TA, Mohd Rahim MS, Siti Zaiton MH, Swee TT, Alhaj TA, Ali A, et al.

Diagnostics (Basel), 2023 Jan 05;13(2).
PMID: 36673006 DOI: 10.3390/diagnostics13020196

Recent advancements in artificial intelligence (AI) have led to numerous medical discoveries. The field of computer vision (CV) for medical diagnosis has received particular attention. Using images of peripheral blood (PB) smears, CV has been utilized in hematology to detect acute leukemia (AL). Significant research has been undertaken in the area of AL diagnosis automation in order to deliver an accurate diagnosis. This study addresses the morphological classification of atypical white blood cells (WBCs), including immature WBCs and atypical lymphocytes, in acute myeloid leukemia (AML), as observed in peripheral blood (PB) smear images. The purpose of this work is to build a classification model for atypical AML WBCs based on their distinctive features. Using a hybrid model based on geometric transformation (GT) and a deep convolutional autoencoder (DCAE), this work provides a novel technique in the field of AI for resolving the issue of imbalanced distribution of WBCs in blood samples, nicknamed the "GT-DCAE WBC augmentation model". In addition, to extract context-free atypical WBC features, this study develops a stable learning paradigm by incorporating WBC segmentation into deep learning. In order to classify atypical WBCs into eight distinct subgroups, a hybrid multiclassification model termed the "two-stage DCAE-CNN atypical WBC classification model" (DCAE-CNN) was developed. The model achieved an average accuracy of 97%, a sensitivity of 97%, and a precision of 98%. Overall and by class, the model's discriminating abilities were exceptional, with an AUC of 99.7% and a class-wise range of 80% to 100%.

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