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Fulltext Fracture Liaison Service and Its Role in Secondary Fracture Prevention in Malaysia: A Scoping Review

Lim WX, Khor HM, Lee JK, Ong T

Malays Orthop J, 2023 Jul;17(2):1-6.
PMID: 37583523 DOI: 10.5704/MOJ.2307.001

INTRODUCTION: Fragility fractures, which occur after a low-trauma injury, increases with advancing age. Such fracture doubles the life-time risk of sustaining another fracture. This risk is highest in the immediate 18 months after the index fracture. However, most patients do not receive the appropriate risk assessment and intervention to reduce this risk. A coordinated model of care termed Fracture Liaison Service (FLS) has been reported to address this treatment gap.
MATERIALS AND METHODS: This scoping review aims to explore the potential role and delivery of FLS services in Malaysia. Scientific and non-scientific sources relevant to FLS were identified from electronic bibliographic databases, specialist journals and relevant websites. Findings were categorised into themes and presented narratively.
RESULTS: FLS services remain concentrated in the Klang Valley. Even within FLS services, many do not have extensive coverage to risk assess all fracture patients. These services are multidisciplinary in nature where there are links between different departments, such as orthopaedics, osteoporosis expertise, bone densitometry, rehabilitation, falls services and primary care. FLS was able to increase the number of people undergoing fracture risk assessment and treatment. The importance of FLS was highlighted by local experts and stakeholders. Its implementation and delivery are supported by a number of national guidelines.
CONCLUSION: FLS is central to our national efforts to reduce the impending fragility fracture crisis in the coming years. Continued effort is needed to increase coverage within FLS services and across the country. Training, awareness of the problem, research, and policy change will support this endeavour.
Fulltext Obesity in South and Southeast Asia-A new consensus on care and management

Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, et al.

Obes Rev, 2023 Feb;24(2):e13520.
PMID: 36453081 DOI: 10.1111/obr.13520

Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
Hip fracture incidence rates in Singapore 1991-1998

Koh LK, Saw SM, Lee JJ, Leong KH, Lee J, National Working Committee on Osteoporosis

Osteoporos Int, 2001;12(4):311-8.
PMID: 11420781

In this population-based study, we determined the incidence rates of hip fracture among Singapore residents aged 50 years and above. Information was obtained from a centralized database system which captured admissions with the primary diagnosis of a closed hip fracture (ICD-9 codes 820, 820.0, 820.2 and 820.8, n = 12,927) from all health care establishments in the country from 1991 to 1998 inclusive. After removing duplicates, hospital transfers, readmissions and non-acute care admissions, the total number of hip fractures was 9406. Based on the national population census 1990 (n = 464,100) and yearly population estimates, the age-adjusted hip fracture rates for 1991-1998 (per 100,000) were 152 in men and 402 in women. This was 1.5 and over 5 times higher than corresponding rates in the 1960s. From 1991 to 1998, these hip fracture rates tended to increase by 0.7% annually in men and by 1.2% annually in women. Among the three major racial groups, in men, the Chinese had significantly higher age-adjusted hip fracture rates (per 100,000): 168 (95% confidence interval (CI) 158-178) compared with 128 (95% CI 105-152) for Indians and 71 (95% CI 54-88) for Malays. A similar pattern occurred in women: 410 (95% CI 395-425), for Chinese compared with 361 (95% CI 290-432) for Indians and 264 (95% CI 225-303) for Malays. Since the 1960s, the main increases in hip fracture rates have been seen in the Chinese and Malays, with the rates in Indians appearing to decrease. Hip fracture incidence rates in Singapore have risen rapidly over the past 30-40 years, particularly in women, and are now among the highest in Asia. Significant racial differences in hip fracture rates occur within the same community. Time trends in hip fracture rates differed between races.
Fulltext Automated System for Identifying COVID-19 Infections in Computed Tomography Images Using Deep Learning Models

Abdulkareem KH, Mostafa SA, Al-Qudsy ZN, Mohammed MA, Al-Waisy AS, Kadry S, et al.

J Healthc Eng, 2022;2022:5329014.
PMID: 35368962 DOI: 10.1155/2022/5329014

Coronavirus disease 2019 (COVID-19) is a novel disease that affects healthcare on a global scale and cannot be ignored because of its high fatality rate. Computed tomography (CT) images are presently being employed to assist doctors in detecting COVID-19 in its early stages. In several scenarios, a combination of epidemiological criteria (contact during the incubation period), the existence of clinical symptoms, laboratory tests (nucleic acid amplification tests), and clinical imaging-based tests are used to diagnose COVID-19. This method can miss patients and cause more complications. Deep learning is one of the techniques that has been proven to be prominent and reliable in several diagnostic domains involving medical imaging. This study utilizes a convolutional neural network (CNN), stacked autoencoder, and deep neural network to develop a COVID-19 diagnostic system. In this system, classification undergoes some modification before applying the three CT image techniques to determine normal and COVID-19 cases. A large-scale and challenging CT image dataset was used in the training process of the employed deep learning model and reporting their final performance. Experimental outcomes show that the highest accuracy rate was achieved using the CNN model with an accuracy of 88.30%, a sensitivity of 87.65%, and a specificity of 87.97%. Furthermore, the proposed system has outperformed the current existing state-of-the-art models in detecting the COVID-19 virus using CT images.
Fulltext Bilateral Open Globe Injury Secondary to the King of Fruits: Durian Fall

Lee J, Che Hamzah J, Mohd Khialdin S, Naffi AA

Cureus, 2023 May;15(5):e39153.
PMID: 37332448 DOI: 10.7759/cureus.39153

We report a case of bilateral open globe injury that resulted from a durian fruit falling on a 62-year-old woman's unprotected face during durian picking in her orchard. On presentation, the bilateral vision was light perception. The right eye sustained a curvilinear corneal laceration with expelled intraocular content. Meanwhile, the left eye sustained a corneoscleral laceration with expelled uvea and retina. Additionally, the right upper lid margin was lacerated. Emergency wound exploration, primary toilet, and suturing were performed on bilateral eyes. Preoperatively, she received intramuscular anti-tetanus toxoid and intravenous ciprofloxacin. Intravitreal ceftazidime and vancomycin were given intraoperatively as endophthalmitis prophylaxis. Postoperatively, the vision remained as light perception. There were no signs of endophthalmitis in both eyes. Although traumatic globe injury due to durian is uncommon, individuals should wear protective gear while in a durian orchard to avoid such unprecedented accidents. Prompt yet scrupulous action should be taken to save the globe and further possible complications.
Fulltext Osmoregulation requires brain expression of the renal Na-K-2Cl cotransporter NKCC2

Konopacka A, Qiu J, Yao ST, Greenwood MP, Greenwood M, Lancaster T, et al.

J Neurosci, 2015 Apr 01;35(13):5144-55.
PMID: 25834041 DOI: 10.1523/JNEUROSCI.4121-14.2015

The Na-K-2Cl cotransporter 2 (NKCC2) was thought to be kidney specific. Here we show expression in the brain hypothalamo-neurohypophyseal system (HNS), wherein upregulation follows osmotic stress. The HNS controls osmotic stability through the synthesis and release of the neuropeptide hormone, arginine vasopressin (AVP). AVP travels through the bloodstream to the kidney, where it promotes water conservation. Knockdown of HNS NKCC2 elicited profound effects on fluid balance following ingestion of a high-salt solution-rats produced significantly more urine, concomitant with increases in fluid intake and plasma osmolality. Since NKCC2 is the molecular target of the loop diuretics bumetanide and furosemide, we asked about their effects on HNS function following disturbed water balance. Dehydration-evoked GABA-mediated excitation of AVP neurons was reversed by bumetanide, and furosemide blocked AVP release, both in vivo and in hypothalamic explants. Thus, NKCC2-dependent brain mechanisms that regulate osmotic stability are disrupted by loop diuretics in rats.
Comparison of social anxiety between Japanese adults who stutter and non-stuttering controls

Chu SY, Sakai N, Lee J, Harrison E, Tang KP, Mori K

J Fluency Disord, 2020 09;65:105767.
PMID: 32535211 DOI: 10.1016/j.jfludis.2020.105767

PURPOSE: Adults who stutter (AWS) often develop social anxiety disorder. This study was to provide comparative data on the Liebowitz Social Anxiety Scale-Japanese version (LSAS-J) from AWS and non-stuttering adult controls.
METHODS: LSAS-J, a 24-item self-reported survey of social phobia and avoidance across various daily situations, was administered to 130 AWS (Mean Age = 41.5 years, SD = 15.8, 111 males) and 114 non-stuttering adults (Mean Age = 39.5, SD = 14.9, 53 males). The test-retest reliability and internal consistency of the LSAS-J were assessed. A between-subject multivariate analysis of variance (MANOVA) was also conducted to determine whether attitude toward social anxiety differed between AWS and AWNS, or by age (<40 and ≥ 40 years old), or sex (female and male).
RESULTS: AWS reported higher scores on both fear subscales of the LSAS-J. Age had no significant influence on the social anxiety levels reported by either participant group. Sex differences were found in the fear subscales, with females scoring higher on both fear subscales, although these were only marginally significant (p = .06). LSAS-J showed good test-retest reliability and high Cronbach's alpha coefficient, indicating that it is an internally consistent measure of attitudes about social anxiety.
CONCLUSION: Given the similarly high incidence of social anxiety in adults in Japan who stutter compared with those in other countries, social anxiety should be identified and assessed during clinical decision making and before decisions are made about stuttering treatment. LSAS-J is an easy tool to administer, and showed reliable results of social phobia and avoidance for AWS.
Public attitudes toward stuttering in Malaysia

Chu SY, Unicomb R, Lee J, Cho KS, St Louis KO, Harrison E, et al.

J Fluency Disord, 2022 Dec;74:105942.
PMID: 36395547 DOI: 10.1016/j.jfludis.2022.105942

PURPOSE: This study aims to: (a) measure public attitudes toward stuttering in Malaysia using the Public Opinion Survey of Human Attitudes-Stuttering [POSHA-S], (b) determine how reported attitudes and knowledge related to stuttering compare to existing data, and (c) determine whether there are differences between groups for identified variables.
METHOD: A total of 250 adults (mean age = 29 years; range = 19-60 years) completed the POSHA-S in English. We compared this sample's attitudes toward stuttering to POSHA-S data from other global samples. General linear modeling examined differences in overall stuttering score, beliefs, and self reaction subscores for demographic variables such as age, gender, marital status, parenting, education, employment status, prior exposure to a person who stutters, multilingual, race, and religion.
RESULTS: The Malaysian participants' overall stuttering score and the beliefs and self reactions subscores were all considerably lower (i.e., less positive) than the other samples around the world from the POSHA-S database median values. Being male, receiving a higher education, and knowing someone who stutters were linked to having more positive self reactions, but none of those factors was linked to positive or negative beliefs. Those who had previously been exposed to stuttering scored significantly higher than those who had not.
CONCLUSION: Malaysians may have less positive attitudes toward stuttering than Westerners. More needs to be done to make society more accepting of people who stutter. Future research should aim to find ways to educate and to raise public awareness about stuttering.
Fine root dynamics across pantropical rainforest ecosystems

Huaraca Huasco W, Riutta T, Girardin CAJ, Hancco Pacha F, Puma Vilca BL, Moore S, et al.

Glob Chang Biol, 2021 08;27(15):3657-3680.
PMID: 33982340 DOI: 10.1111/gcb.15677

Fine roots constitute a significant component of the net primary productivity (NPP) of forest ecosystems but are much less studied than aboveground NPP. Comparisons across sites and regions are also hampered by inconsistent methodologies, especially in tropical areas. Here, we present a novel dataset of fine root biomass, productivity, residence time, and allocation in tropical old-growth rainforest sites worldwide, measured using consistent methods, and examine how these variables are related to consistently determined soil and climatic characteristics. Our pantropical dataset spans intensive monitoring plots in lowland (wet, semi-deciduous, and deciduous) and montane tropical forests in South America, Africa, and Southeast Asia (n = 47). Large spatial variation in fine root dynamics was observed across montane and lowland forest types. In lowland forests, we found a strong positive linear relationship between fine root productivity and sand content, this relationship was even stronger when we considered the fractional allocation of total NPP to fine roots, demonstrating that understanding allocation adds explanatory power to understanding fine root productivity and total NPP. Fine root residence time was a function of multiple factors: soil sand content, soil pH, and maximum water deficit, with longest residence times in acidic, sandy, and water-stressed soils. In tropical montane forests, on the other hand, a different set of relationships prevailed, highlighting the very different nature of montane and lowland forest biomes. Root productivity was a strong positive linear function of mean annual temperature, root residence time was a strong positive function of soil nitrogen content in montane forests, and lastly decreasing soil P content increased allocation of productivity to fine roots. In contrast to the lowlands, environmental conditions were a better predictor for fine root productivity than for fractional allocation of total NPP to fine roots, suggesting that root productivity is a particularly strong driver of NPP allocation in tropical mountain regions.
The appearance of a second genotype of Japanese encephalitis virus in the Australasian region

Pyke AT, Williams DT, Nisbet DJ, van den Hurk AF, Taylor CT, Johansen CA, et al.

Am J Trop Med Hyg, 2001 Dec;65(6):747-53.
PMID: 11791969

In mid-January 2000, the reappearance of Japanese encephalitis (JE) virus activity in the Australasian region was first demonstrated by the isolation of JE virus from 3 sentinel pigs on Badu Island in the Torres Strait. Further evidence of JE virus activity was revealed through the isolation of JE virus from Culex gelidus mosquitoes collected on Badu Island and the detection of specific JE virus neutralizing antibodies in 3 pigs from Saint Pauls community on Moa Island. Nucleotide sequencing and phylogenetic analyses of the premembrane and envelope genes were performed which showed that both the pig and mosquito JE virus isolates (TS00 and TS4152, respectively) clustered in genotype I, along with northern Thai, Cambodian, and Korean isolates. All previous Australasian JE virus isolates belong to genotype II, along with Malaysian and Indonesian isolates. Therefore, for the first time, the appearance and transmission of a second genotype of JE virus in the Australasian region has been demonstrated.
Fulltext Analysis of non-synonymous-coding variants of Parkinson's disease-related pathogenic and susceptibility genes in East Asian populations

Foo JN, Tan LC, Liany H, Koh TH, Irwan ID, Ng YY, et al.

Hum Mol Genet, 2014 Jul 15;23(14):3891-7.
PMID: 24565865 DOI: 10.1093/hmg/ddu086

To evaluate the contribution of non-synonymous-coding variants of known familial and genome-wide association studies (GWAS)-linked genes for Parkinson's disease (PD) to PD risk in the East Asian population, we sequenced all the coding exons of 39 PD-related disease genes and evaluated the accumulation of rare non-synonymous-coding variants in 375 early-onset PD cases and 399 controls. We also genotyped 782 non-synonymous-coding variants of these genes in 710 late-onset PD cases and 9046 population controls. Significant enrichment of LRRK2 variants was observed in both early- and late-onset PD (odds ratio = 1.58; 95% confidence interval = 1.29-1.93; P = 8.05 × 10(-6)). Moderate enrichment was also observed in FGF20, MCCC1, GBA and ITGA8. Half of the rare variants anticipated to cause loss of function of these genes were present in healthy controls. Overall, non-synonymous-coding variants of known familial and GWAS-linked genes appear to make a limited contribution to PD risk, suggesting that clinical sequencing of these genes will provide limited information for risk prediction and molecular diagnosis.
Microenvironment-tailored nanoassemblies for the diagnosis and therapy of neurodegenerative diseases

Low LE, Wang Q, Chen Y, Lin P, Yang S, Gong L, et al.

Nanoscale, 2021 Jun 17;13(23):10197-10238.
PMID: 34027535 DOI: 10.1039/d1nr02127c

Neurodegenerative disorder is an illness involving neural dysfunction/death attributed to complex pathological processes, which eventually lead to the mortality of the host. It is generally recognized through features such as mitochondrial dysfunction, protein aggregation, oxidative stress, metal ions dyshomeostasis, membrane potential change, neuroinflammation and neurotransmitter impairment. The aforementioned neuronal dysregulations result in the formation of a complex neurodegenerative microenvironment (NME), and may interact with each other, hindering the performance of therapeutics for neurodegenerative disease (ND). Recently, smart nanoassemblies prepared from functional nanoparticles, which possess the ability to interfere with different NME factors, have shown great promise to enhance the diagnostic and therapeutic efficacy of NDs. Herein, this review highlights the recent advances of stimuli-responsive nanoassemblies that can effectively combat the NME for the management of ND. The first section outlined the NME properties and their interrelations that are exploitable for nanoscale targeting. The discussion is then extended to the controlled assembly of functional nanoparticles for the construction of stimuli-responsive nanoassemblies. Further, the applications of stimuli-responsive nanoassemblies for the enhanced diagnosis and therapy of ND are introduced. Finally, perspectives on the future development of NME-tailored nanomedicines are given.
Tumor-responsive dynamic nanoassemblies for targeted imaging, therapy and microenvironment manipulation

Low LE, Wu J, Lee J, Tey BT, Goh BH, Gao J, et al.

J Control Release, 2020 Aug 10;324:69-103.
PMID: 32423874 DOI: 10.1016/j.jconrel.2020.05.014

The recent designs of dynamic nanoassemblies exploiting the tumor-targeting properties have received increasing attention for tumor imaging and therapy due to their tumor-specific delivery and enhanced antitumor efficacy. However, these designs are mainly focused on the macroscopic tumor therapeutic effect, while the nano-bio interactions in the tumor microenvironment (TME) remain poorly understood. This review aims to provide an overview of the development of tumor-responsive nanoassemblies towards the imaging, therapy and TME modulation in the tumor site. The tumor biology leading to TME formation and the potential TME properties for the practicable design of tumor-targeting nanoassemblies has been outlined. Furthermore, the various approaches for TME modification and the realization via dynamic nanoassemblies for enhanced tumor therapy were reviewed. Lastly, the prospects of these methods were briefly discussed. These strategies may inspire the development of new combinational cancer therapeutics.
Fulltext Dynamically switchable magnetic resonance imaging contrast agents

Wang Q, Liang Z, Li F, Lee J, Low LE, Ling D

Exploration (Beijing), 2021 Oct;1(2):20210009.
PMID: 37323214 DOI: 10.1002/EXP.20210009

Contrast agents can improve the sensitivity and resolution of magnetic resonance imaging (MRI) by accelerating the relaxation times of surrounding water protons. The MRI performances of contrast agents are closely related to their structural characteristics, including size, shape, surface modification, and so on. Recently, dynamically switchable MRI contrast agents that can undergo structural changes and imaging functional activations upon reaching the disease microenvironment have been developed for high performance MRI. This perspective highlights the ingenious design, controllable structural transformation, and tunable imaging property of dynamic MRI contrast agents. Additionally, the current challenges of the dynamic MRI contrast agents for medical diagnosis are discussed. Furthermore, the future integration of high-resolution ultra-high field MRI technology and cutting-edge dynamic MRI contrast agents for non-invasive histopathological level accurate detection of microscopic lesions are commented.
The relationship between affiliate stigma, stress, and quality of life for parents of individuals with cerebral palsy in Malaysia

Chu SY, Rafi ABM, Lee J, Fierro V, Gan CH, Joginder Singh S, et al.

Disabil Rehabil, 2023 Dec;45(24):4035-4047.
PMID: 36541160 DOI: 10.1080/09638288.2022.2153304

OBJECTIVE: To examine the relationship between affiliate stigma, stress, and perceived quality of life among parents of children with cerebral palsy (CP).
METHOD: Surveys (Study 1) and semi-structured interviews (Study 2) were used to collect data. Thirty-eight respondents completed the Affiliate Stigma Scale (ASS), Caregiver Burden Inventory (CBI), and Care-related Quality of Life (CarerQol) scales (GMFCS). Eleven respondents took part in semi-structured interviews, which were then thematically evaluated.
RESULTS: Parents did not feel stigmatized because they had a child with CP. However, parents needed some form of short-term relief from caregiving. After controlling for demographics, high stress respondents experienced high affiliate stigma whereas low stress respondents had better quality of life. Although the respondents with less stigma had a better quality of life, this effect was moderate. Three major themes emerged from the interviews.
CONCLUSION: Counseling, support groups, and helper services should be offered to parents. Also, healthcare professionals participating in CP rehabilitation, community-based rehabilitation, and health institutions should be educated on how to better help parents of children with CP.
Metal-complexed covalent organic frameworks derived N-doped carbon nanobubble-embedded cobalt nanoparticle as a magnetic and efficient catalyst for oxone activation

Nguyen HT, Lee J, Kwon E, Lisak G, Thanh BX, Oh WD, et al.

J Colloid Interface Sci, 2021 Jun;591:161-172.
PMID: 33601102 DOI: 10.1016/j.jcis.2021.01.108

While Cobalt nanoparticles (Co NPs) are useful for catalytic Oxone activation, it is more advantageous to embed/immobilize Co NPs on nitrogen-doped carbon substrates to provide synergy for enhancing catalytic performance. Herein, this study proposes to fabricate such a composite by utilizing covalent organic frameworks (COF) as a precursor. Through complexation of COF with Co, a stable product of Co-complexed COF (Co-COF) can be synthesized. This Co-COF is further converted through pyrolysis to N-doped carbon in which cobaltic NPs are embedded. Owing to its well-defined structures of Co-COF, the pyrolysis process transforms COF into N-doped carbon with a bubble-like morphology. Such Co NP-embedded N-doped carbon nanobubbles (CoCNB) with pores, magnetism and Co, shall be a promising catalyst. Thus, CoCNB shows a much stronger catalytic activity than commercial Co3O4 NPs to activate Oxone to degrade toxic Amaranth dye (AMD). CoCNB-activated Oxone also achieves a significantly lower Ea value of AMD degradation (i.e., 27.9 kJ/mol) than reported Ea values in previous literatures. Besides, CoCNB is still effective for complete elimination of AMD in the presence of high-concentration NaCl and surfactants, and CoCNB is also reusable over five consecutive cycles.
Hierarchical ZIF-decorated nanoflower-covered 3-dimensional foam for enhanced catalytic reduction of nitrogen-containing contaminants

Lin JY, Lee J, Oh WD, Kwon E, Tsai YC, Lisak G, et al.

J Colloid Interface Sci, 2021 Nov 15;602:95-104.
PMID: 34118608 DOI: 10.1016/j.jcis.2021.05.098

Metal Organic Frameworks (MOFs) represent a promising class of metallic catalysts for reduction of nitrogen-containing contaminants (NCCs), such as 4-nitrophenol (4-NP). Nevertheless, most researches involving MOFs for 4-NP reduction employ noble metals in the form of fine powders, making these powdered noble metal-based MOFs impractical and inconvenient for realistic applications. Thus, it would be critical to develop non-noble-metal MOFs which can be incorporated into macroscale and porous supports for convenient applications. Herein, the present study proposes to develop a composite material which combines advantageous features of macroscale/porous supports, and nanoscale functionality of MOFs. In particular, copper foam (CF) is selected as a macroscale porous medium, which is covered by nanoflower-structured CoO to increase surfaces for growing a cobaltic MOF, ZIF-67. The resultant composite comprises of CF covered by CoO nanoflowers decorated with ZIF-67 to form a hierarchical 3D-structured catalyst, enabling this ZIF-67@Cu foam (ZIF@CF) a promising catalyst for reducing 4-NP, and other NCCs. Thus, ZIF@CF can readily reduce 4-NP to 4-AP with a significantly lower Ea of 20 kJ/mol than reported values. ZIF@CF could be reused over 10 cycles and remain highly effective for 4-NP reduction. ZIF@CF also efficiently reduces other NCCs, such as 2-nitrophenol, 3-nitrophenol, methylene blue, and methyl orange. ZIF@CF can be adopted as catalytic filters to enable filtration-type reduction of NCCs by passing NCC solutions through ZIF@CF to promptly and conveniently reduce NCCs. The versatile and advantageous catalytic activity of ZIF@CF validates that ZIF@CF is a promising and practical heterogeneous catalyst for reductive treatments of NCCs.
Fulltext Psychiatric Sequelae of Former "Comfort Women," Survivors of the Japanese Military Sexual Slavery during World War II

Lee J, Kwak YS, Kim YJ, Kim EJ, Park EJ, Shin Y, et al.

Psychiatry Investig, 2018 Apr;15(4):336-343.
PMID: 29669407 DOI: 10.30773/pi.2017.11.08.2

"Comfort women" refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. "Comfort women" endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former "comfort women" currently alive in South Korea is introduced. The participants' unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former "comfort women" after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former "comfort women" throughout their lives, and even to the present day.
Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities

Kim WJ, Gupta V, Nishimura M, Makita H, Idolor L, Roa C, et al.

Int J Tuberc Lung Dis, 2018 07 01;22(7):820-826.
PMID: 29914609 DOI: 10.5588/ijtld.17.0524

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment.
OBJECTIVE: To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup.
METHODS: Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities. We compared the 1-year change in forced expiratory volume in one second (FEV1), modified Medical Research Council dyspnoea scale score, St George's Respiratory Questionnaire (SGRQ) score and exacerbations according to subgroup derived from cluster analysis.
RESULTS: Factor analysis revealed that body mass index, Charlson comorbidity index, SGRQ total score and FEV1 were principal factors. Using these four factors, cluster analysis identified three distinct subgroups with differing disease severity and symptoms. Among the three subgroups, patients in subgroup 2 (severe disease and more symptoms) had the most frequent exacerbations, most rapid FEV1 decline and greatest decline in SGRQ total score.
CONCLUSION: Three subgroups with differing severities and symptoms were identified in Asian COPD subjects.
Fulltext Perceptions of heat-health impacts and the effects of knowledge and preventive actions by outdoor workers in Hanoi, Vietnam

Lohrey S, Chua M, Gros C, Faucet J, Lee JKW

Sci Total Environ, 2021 Nov 10;794:148260.
PMID: 34328123 DOI: 10.1016/j.scitotenv.2021.148260

Extreme heat is an increasing climate threat, most pronounced in urban areas where poor populations are at particular risk. We analyzed heat impacts and vulnerabilities of 1027 outdoor workers who participated in a KAP survey in Hanoi, Vietnam in 2018, and the influence of their mitigation actions, their knowledge of heat-risks, and access to early warnings. We grouped respondents by their main income (vendors, builders, shippers, others, multiple jobs, and non-working) and analyzed their reported heat-health impacts, taking into consideration socioeconomics, knowledge of heat impacts and preventive measures, actions taken, access to air-conditioning, drinking amounts and use of weather forecasts. We applied linear and logistic regression analyses using R. Construction workers were younger and had less knowledge of heat-health impacts, but also reported fewer symptoms. Older females were more likely to report symptoms and visit a doctor. Access to air-conditioning in the bedroom depended on age and house ownership, but did not influence heat impacts as cooling was too expensive. Respondents who knew more heat exhaustion symptoms were more likely to report impacts (p < 0.01) or consult a doctor (p < 0.05). Similarly, those who checked weather updates were more likely to report heat impacts (p < 0.01) and experienced about 0.6 more symptoms (p < 0.01). Even though occupation type did not explain heat illness, builders knew considerably less (40%; p < 0.05) about heat than other groups but were twice as likely to consult a doctor than street vendors (p < 0.01). Knowledge of preventive actions and taking these actions both correlated positively with reporting of heat-health symptoms, while drinking water did not reduce these symptoms (p < 0.01). Child carers and homeowners experienced income losses in heatwaves (p < 0.01). The differences support directed actions, such as dissemination of educational materials and weather forecasts for construction workers. The Red Cross assisted all groups with cooling tents, provision of drinks and health advice.

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