Diabetes is one of the quickest-growing global health emergencies of the twenty-first century, and data-driven care can improve the quality of diabetes management. We aimed to describe the formation of a 10-year retrospective open cohort of type 2 diabetes patients in Malaysia. We also described the baseline treatment profiles and HbA1c, blood pressure, and lipid control to assess the quality of diabetes care. We used 10 years of cross-sectional audit datasets from the National Diabetes Registry and merged 288,913 patients with the same identifying information into a 10-year open cohort dataset. Treatment targets for HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, and triglycerides were based on Malaysian clinical practice guidelines. IBM SPSS Statistics version 23.0 was used, and frequencies and percentages with 95% confidence intervals were reported. In total, 288,913 patients were included, with 62.3% women and 54.1% younger adults. The commonest diabetes treatment modality was oral hypoglycaemic agents (75.9%). Meanwhile, 19.3% of patients had ≥ 3 antihypertensive agents, and 71.2% were on lipid-lowering drugs. Metformin (86.1%), angiotensin-converting enzyme inhibitors (49.6%), and statins (69.2%) were the most prescribed antidiabetic, antihypertensive, and lipid-lowering medications, respectively. The mean HbA1c was 7.96 ± 2.11, and 31.2% had HbA1c > 8.5%. Only 35.8% and 35.2% attained blood pressure
Pristine tropical river systems are coming under increasing pressure from the development of economic resources such as forestry and mining for valuable elements. The Lebir catchment, north eastern Malaysia, is now under development as a result of unregulated tree felling and mining for essential and rare metals. Two sediment cores, one in the upstream reaches and the other from the downstream reaches, were taken from flood prone area of the Lebir River, Malaysia, and analysed for their elemental composition by XRF, specifically Al, Si, Fe, Ca, K, Mg, Mn, V, Cu, Ni, Pb, Cr, Zn, As, Th and U. Activities of fallout radionuclides, 137Cs and 210Pb were also determined to from a geochronological context. The elemental concentrations in the soils were assessed in terms of their enrichment factor and Si, Ca, K, Mg, Mn, V, Cu, Ni and Zn were found not to be enriched, whereas As, Th and U had elevated enrichment factors. The Th and U were particularly enriched in the downstream core indicating inputs from a tributary that drains a catchment with known deposits of Th and possibly U. The results suggest that the growth in economic development is fostering the transport of contaminants by the major rivers which, in turn, is contaminating the riverine floodplains. This points to the need for a more integrated and holistic approach to river basin management to maintain the environmental quality of these fragile aquatic systems.
Sonic pressure wave should be taken into consideration in all ballistic injury. We review a young gentleman with ballistic injury of his lateral chest wall. The bullet trajectory passed through the lateral chest wall. Chest radiograph shows a wedge-shaped consolidation adjacent to the wound with blunted right costophrenic angle. Subsequent CT scan confirms the consolidation adjacent to the bullet trajectory. This case report emphasizes on value of CT in ballistic chest trauma and indirect injury caused by the sonic pressure wave of the bullet.
Marine sponges are sessile invertebrates that can be found in temperate, polar and tropical regions. They are known to be major contributors of bioactive compounds, which are discovered in and extracted from the marine environment. The compounds extracted from these sponges are known to exhibit various bioactivities, such as antimicrobial, antitumor and general cytotoxicity. For example, various compounds isolated from Theonella swinhoei have showcased various bioactivities, such as those that are antibacterial, antiviral and antifungal. In this review, we discuss bioactive compounds that have been identified from marine sponges that showcase the ability to act as antibacterial, antiviral, anti-malarial and antifungal agents against human pathogens and fish pathogens in the aquaculture industry. Moreover, the application of such compounds as antimicrobial agents in other veterinary commodities, such as poultry, cattle farming and domesticated cats, is discussed, along with a brief discussion regarding the mode of action of these compounds on the targeted sites in various pathogens. The bioactivity of the compounds discussed in this review is focused mainly on compounds that have been identified between 2000 and 2020 and includes the novel compounds discovered from 2018 to 2021.
In this study, we present our findings from investigating the use of a machine learning (ML) technique to improve the performance of Quasi-Yagi-Uda antennas operating in the n78 band for 5G applications. This research study investigates several techniques, such as simulation, measurement, and an RLC equivalent circuit model, to evaluate the performance of an antenna. In this investigation, the CST modelling tools are used to develop a high-gain, low-return-loss Yagi-Uda antenna for the 5G communication system. When considering the antenna's operating frequency, its dimensions are [Formula: see text]. The antenna has an operating frequency of 3.5 GHz, a return loss of [Formula: see text] dB, a bandwidth of 520 MHz, a maximum gain of 6.57 dB, and an efficiency of almost 97%. The impedance analysis tools in CST Studio's simulation and circuit design tools in Agilent ADS software are used to derive the antenna's equivalent circuit (RLC). We use supervised regression ML method to create an accurate prediction of the frequency and gain of the antenna. Machine learning models can be evaluated using a variety of measures, including variance score, R square, mean square error, mean absolute error, root mean square error, and mean squared logarithmic error. Among the nine ML models, the prediction result of Linear Regression is superior to other ML models for resonant frequency prediction, and Gaussian Process Regression shows an extraordinary performance for gain prediction. R-square and var score represents the accuracy of the prediction, which is close to 99% for both frequency and gain prediction. Considering these factors, the antenna can be deemed an excellent choice for the n78 band of a 5G communication system.
The actual prevalence of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D) in Malaysia is unknown. We aimed to determine the prevalence of DKD and its associated risk factors among T2D patients in Malaysia. An analytical cross-sectional study was conducted using the year 2022 clinical audit dataset from the National Diabetes Registry. DKD was defined as albuminuria, a decreased glomerular filtration rate, or both. Among 80,360 patients, 62.2% were female, 68.4% were Malay, and the mean age was 61.4 years. A total of 56.7% (95% CI 56.4-57.1%) of patients were found to have DKD. Increasing age, male sex, Malay ethnicity, longer duration of diabetes, overweight, obesity, hypertension, diabetic retinopathy, diabetic foot ulcer, nontraumatic lower-extremity amputation, ischaemic heart disease, stroke, insulin, higher numbers of antihypertensive agents, antiplatelet agents, poorer HbA1c control, higher systolic blood pressure, non-achievement of triglyceride target, and non-attainment of HDL-cholesterol goal were independent risk factors associated with DKD. Clinicians, program managers, and health policymakers should target modifiable factors to manage DKD and prevent its progression to end-stage kidney disease in Malaysia.
Although the role of nuclear-encoded gene alterations has been well documented in brain tumor development, the involvement of the mitochondrial genome in brain tumorigenesis has not yet been fully elucidated and remains controversial. The present study aimed to identify mutations in the mitochondrial DNA (mtDNA) control region D-loop in patients with brain tumors in Malaysia. A mutation analysis was performed in which DNA was extracted from paired tumor tissue and blood samples obtained from 49 patients with brain tumors. The D-loop region DNA was amplified using the PCR technique, and genetic data from DNA sequencing analyses were compared with the published revised Cambridge sequence to identify somatic mutations. Among the 49 brain tumor tissue samples evaluated, 25 cases (51%) had somatic mutations of the mtDNA D-loop, with a total of 48 mutations. Novel mutations that had not previously been identified in the D-loop region (176 A-deletion, 476 C>A, 566 C>A and 16405 A-deletion) were also classified. No significant associations between the D-loop mutation status and the clinicopathological parameters were observed. To the best of our knowledge, the current study presents the first evidence of alterations in the mtDNA D-loop regions in the brain tumors of Malaysian patients. These results may provide an overview and data regarding the incidence of mitochondrial genome alterations in Malaysian patients with brain tumors. In addition to nuclear genome aberrations, these specific mitochondrial genome alterations may also be considered as potential cancer biomarkers for the diagnosis and staging of brain cancers.
Left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular morbidity and mortality, and a powerful predictor of adverse cardiovascular outcomes in the hypertensive patients. It has complex multifactorial and polygenic basis for its pathogenesis. We hypothesized that rare copy number variants (CNVs) contribute to the LVH pathogenesis in hypertensive patients. Copy number variants (CNV) were identified in 258 hypertensive patients, 95 of whom had LVH, after genotyping with a high resolution SNP array. Following stringent filtering criteria, we identified 208 rare, or private CNVs that were only present in our patients with hypertension related LVH. Preliminary findings from Gene Ontology and pathway analysis of this study confirmed the involvement of the genes known to be functionally involved in cardiac development and phenotypes, in line with previously reported transcriptomic studies. Network enrichment analyses suggested that the gene-set was, directly or indirectly, involved in the transcription factors regulating the "foetal cardiac gene programme" which triggered the hypertrophic cascade, confirming previous reports. These findings suggest that multiple, individually rare copy number variants altering genes may contribute to the pathogenesis of hypertension-related LVH. In summary, we have provided further supporting evidence that rare CNV could potentially impact this common and complex disease susceptibility with lower heritability.
Shortening derived from palm oil is widely used in baking applications. However, palm oil and the related products are reported to contain high levels of monochloropropandiol (MCPD) ester and glycidyl ester (GE). MCPD and glycidol are known as process contaminants, which are carcinogenic and genotoxic compounds, respectively. The objective was to evaluate the effects of antioxidant addition in palm olein and stearin to the content of MCPD esters and GE in baked cake. Butylated hydroxyanisole (BHA), rosemary extract and tocopherol were used to fortify the samples at 200 mg/kg and in combinations (400, 600 and 800 mg/kg rosemary or tocopherol combined with 200 mg/kg BHA). The MCPD esters and GE content, radical formation and the quality of the fats portion were analyzed. The results showed that palm olein fortified with rosemary extract yielded less 2-MCPD ester. The GE content was lower when soft stearin was fortified with rosemary. ESR spectrometry measurements showed that the antioxidants were effective to reduce radical formation. The synergistic effects of combining antioxidants controlled the contaminants formation. In conclusion, oxidation stability was comparable either in the single or combined antioxidants. Tocopherol in combination with BHA was more effective in controlling the MCPD esters and GE formation.
Newcastle disease virus (NDV) is an avian virus that causes deadly infection to over 250 species of birds, including domestic and wild-type, thus resulting in substantial losses to the poultry industry worldwide. Many reports have demonstrated the oncolytic effect of NDV towards human tumor cells. The interesting aspect of NDV is its ability to selectively replicate in cancer cells. Some of the studies have undergone human clinical trials, and favorable results were obtained. Therefore, NDV strains can be the potential therapeutic agent in cancer therapy. However, investigation on the therapeutic perspectives of NDV, especially human immunological effects, is still ongoing. This paper provides an overview of the current studies on the cytotoxic and anticancer effect of NDV via direct oncolysis effects or immune stimulation. Safety of NDV strains applied for cancer immunotherapy is also discussed in this paper.
Bacterial biofilms are a preferred mode of growth for many types of microorganisms in their natural environments. The ability of pathogens to integrate within a biofilm is pivotal to their survival. The possibility of biofilm formation in Lactobacillus communities is also important in various industrial and medical settings. Lactobacilli can eliminate the colonization of different pathogenic microorganisms. Alternatively, new opportunities are now arising with the rapidly expanding potential of lactic acid bacteria biofilms as bio-control agents against food-borne pathogens.
Strawberry (Fragaria ananassa) is rich in bioactive compounds with high antioxidant activity. High pressure processing (HPP) is an efficient alternative to preserve these bioactive compounds in terms of microbial inactivation and shelf-life stability. This review compares the effects of pasteurization methods using high pressure or thermal pasteurization (TP) on the quality parameters of various strawberry-based products. To summarize, most of the high pressure-treated products are microbiologically stable and showed minimum degradation of thermolabile compounds than TP-treated ones. However, some studies reported that high pressure did not have an advantage over TP especially in the preservation of phenolic phytochemicals during storage. The insufficient enzyme inactivation and high residual activity of enzymes after high pressure treatment could cause anthocyanins degradation thus affecting the product quality. Overall, this review could be valuable to potential processors in evaluating the effective commercialization of high pressure-treated strawberry products.
Introduction. This study aims to evaluate the effectiveness of Tualang honey on sperm parameters, erectile function, and hormonal and safety profiles. Methodology. A randomized control trial was done using Tualang honey (20 grams) and Tribestan (750 mg) over a period of 12 weeks. Sperm parameters including sperm concentration, motility, and morphology were analyzed and erectile function was assessed using IIEF-5 questionnaire. Hormonal profiles of testosterone, FSH, and LH were studied. The volunteers were randomized into two groups and the outcomes were analyzed using SPSS version 18. Results. A total of 66 participants were involved. A significant increment of mean sperm concentration (P < 0.001), motility (P = 0.015) and morphology (P = 0.008) was seen in Tualang honey group. In Tribestan group, a significant increment of mean sperm concentration (P = 0.007), and morphology (P = 0.009) was seen. No significant differences of sperm concentration, motility, and morphology were seen between Tualang honey and Tribestan group and similar results were also seen in erectile function and hormonal profile. All safety profiles were normal and no adverse event was reported. Conclusion. Tualang honey effect among oligospermic males was comparable with Tribestan in improving sperm concentration, motility, and morphology. The usage of Tualang honey was also safe with no reported adverse event.
Burkitt lymphoma (BL) is a form of B-cell malignancy that progresses aggressively and is most often seen in children. While Epstein-Barr virus (EBV) is a double-stranded DNA virus that has been linked to a variety of cancers, it can transform B lymphocytes into immortalized cells, as shown in BL. Therefore, the estimated prevalence of EBV in a population may assist in the prediction of whether this population has a high risk of increased BL cases. This systematic review and meta-analysis aimed to estimate the prevalence of Epstein-Barr virus in patients with Burkitt lymphoma. Using the appropriate keywords, four electronic databases were searched. The quality of the included studies was assessed using the Joanna Briggs Institute's critical appraisal tool. The results were reported as percentages with a 95% confidence interval using a random-effects model (CI). PROSPERO was used to register the protocol (CRD42022372293), and 135 studies were included. The prevalence of Epstein-Barr virus in patients with Burkitt lymphoma was 57.5% (95% CI: 51.5 to 63.4, n = 4837). The sensitivity analyses demonstrated consistent results, and 65.2% of studies were of high quality. Egger's test revealed that there was a significant publication bias. EBV was found in a significantly high proportion of BL patients (more than 50% of BL patients). This study recommends EBV testing as an alternative for predictions and the assessment of the clinical disease status of BL.
Bisphenol A (BPA) is a well-known endocrine-disrupting compound that causes several toxic effects on human and aquatic organisms. The restriction of BPA in several applications has increased the substituted toxic chemicals such as bisphenol F (BPF) and bisphenol S (BPS). A native tropical freshwater cladoceran, Moina micrura, was used as a bioindicator to assess the adverse effects of bisphenol analogues at molecular, organ, individual and population levels. Bisphenol analogues significantly upregulated the expressions of stress-related genes, which are the haemoglobin and glutathione S-transferase genes, but the sex determination genes such as doublesex and juvenile hormone analogue genes were not significantly different. The results show that bisphenol analogues affect the heart rate and mortality rate of M. micrura. The 48-h lethal concentration (LC50) values based on acute toxicity for BPA, BPF and BPS were 611.6 µg L-1, 632.0 µg L-1 and 819.1 µg L-1, respectively. The order of toxicity based on the LC50 and predictive non-effect concentration values were as follows: BPA > BPF > BPS. Furthermore, the incorporated method combining the responses throughout the organisation levels can comprehensively interpret the toxic effects of bisphenol analogues, thus providing further understanding of the toxicity mechanisms. Moreover, the output of this study produces a comprehensive ecotoxicity assessment, which provides insights for the legislators regarding exposure management and mitigation of bisphenol analogues in riverine ecosystems.
A modified outdoor large-scale nutrient recycling system was developed to compost organic sludge and aimed to recover clean nitrogen for the cultivation of high-value-added microalgae. This study investigated the effect of calcium hydroxide addition on enhancing NH3 recovery in a pilot-scale reactor self-heated by metabolic heat of microorganisms during thermophilic composting of dewatered cow dung. 350 kg-ww of compost was prepared at the ratio of 5: 14: 1 (dewatered cowdung: rice husk: compost-seed) in a 4 m3 cylindrical rotary drum composting reactor for 14 days of aerated composting. High compost temperature up to 67 °C was observed from day 1 of composting, proving that thermophilic composting was achieved through the self-heating process. The temperature of compost increases as microbial activity increases and temperature decreases as organic matter decreases. The high CO2 evolution rate on day 0-2 (0.02-0.08 mol/min) indicated that microorganisms are most active in degrading organic matter. The increasing conversion of carbon demonstrated that organic carbon was degraded by microbial activity and emitted as CO2. The nitrogen mass balance revealed that adding calcium hydroxide to the compost and increasing the aeration rate on day 3 volatilized 9.83 % of the remaining ammonium ions in the compost, thereby improving the ammonia recovery. Moreover, Geobacillus was found to be the most dominant bacteria under elevated temperature that functions in the hydrolysis of non-dissolved nitrogen for better NH3 recovery. The presented results show that by thermophilic composting 1 ton-ds of dewatered cowdung for NH3 recovery, up to 11.54 kg-ds of microalgae can be produced.
Renewable energy consumption is a crucial solution to addressing pressing environmental issues, particularly climate change and air pollution. Investigating the factors that drive its adoption is highly significant, as it provides policymakers and stakeholders with valuable insights to accelerate the transition to renewable energy sources. Through this approach, we can minimise the negative consequences of our reliance on fossil fuels, thereby protecting the integrity of the environment. Therefore, the primary goal of this study is to thoroughly investigate the main factors that influence renewable energy consumption and environmental change in six specifically chosen ASEAN countries. The stationarity of the 1990-2019 data was tested using panel data techniques such as Levin, Lin, and Chu (LLC), Im Pesaran (IPS), and the Shin W-stat test. According to the stationarity tests, after the first order, all variables exhibit stationarity. Additionally, Pedroni's co-integration test result confirmed that there was a long-term relationship among the variables. Different methods, such as dynamic ordinary least squares (DOLS), fully modified ordinary least squares (FMOLS), and pooled ordinary least squares (POLS), are used for cointegration estimating. The results suggest that there is a positive co-integration between renewable energy use and GDP in six ASEAN countries, indicating a long-term relationship. The positive relationship between GDP and renewable energy use suggests that economic growth is the primary driving force behind ASEAN's renewable energy adoption. However, factors like carbon emissions, population density, and foreign direct investment (FDI) negatively impact the demand for renewable energy. The limited availability of renewable energy in certain ASEAN countries may discourage foreign direct investment (FDI) due to the inverse relationship between FDI and renewable energy use. The studies also revealed that carbon emissions, which contribute to environmental pollution, do not motivate industries to invest in renewable energy. This finding would challenge the Environmental Kuznets Curve (EKC) hypothesis. According to the EKC, there is a significant transition towards renewable energy as a response to environmental degradation. However, it is worth noting that several ASEAN countries have experienced economic growth while also experiencing higher levels of carbon emissions. Given that economic expansion might not be environmentally beneficial, this research has implications for ASEAN energy policies. The ASEAN region faces a challenge in investing in renewable energy due to the excessive dependence on fossil fuels. Therefore, an in-depth evaluation of the main factor behind ASEAN's environmental concerns, which promotes the adoption of renewable energy, can greatly influence policy decisions, particularly in attaining net zero emissions. Policymakers can utilise this comprehensive analysis to establish informed objectives for policies related to renewable energy and develop strategic plans, i.e. reforming fuel subsidies. The goal is to encourage the development of environmentally friendly and sustainable energy plans for the future in the ASEAN region.
Perovskite solar cells (PSC) have developed rapidly since the past decade with the aim to produce highly efficient photovoltaic technology at a low cost. Recently, physical and chemical defects at the buried interface of PSC including vacancies, impurities, lattice strain, and voids are identified as the next formidable hurdle to the further advancement of the performance of devices. The presence of these defects has unfavorably impacted many optoelectronic properties in the PSC, such as band alignment, charge extraction/recombination dynamics, ion migration behavior, and hydrophobicity. Herein, a broad but critical discussion on various essential aspects related to defects at the buried interface is provided. In particular, the defects existing at the surface of the underlying charge transporting layer (CTL) and the bottom surface of the perovskite film are initially elaborated. In situ and ex situ characterization approaches adopted to unveil hidden defects are elucidated to determine their influence on the efficiency, operational stability, and photocurrent-voltage hysteresis of PSC. A myriad of innovative strategies including defect management in CTL, the introduction of passivation materials, strain engineering, and morphological control used to address defects are also systematically elucidated to catalyze the further development of more efficient, reliable, and commercially viable photovoltaic devices.
This study was conducted to investigate the effect of docosahexanoic acid (DHA) supplementation in BioXcell extender on the quality of frozen-thawed bull semen. Twenty-four ejaculates were collected from three bulls (eight from each bull). Ejaculates with motility ≥70% and normal morphology ≥80% were extended into BioXcell extender to which 0 (control), 3, 5, 10 or 15ngmL(-1) DHA was added. The supplemented semen samples were incubated at 37°C for 15min for DHA uptake by spermatozoa. Later, samples were cooled for 2h at 5°C and packaged into 0.25-mL straws, frozen in liquid nitrogen for 24h and subsequently thawed for evaluation. Results are presented as percentages ± s.e.m. Supplementation with DHA at 3ngmL(-1) significantly improved sperm functional parameters including sperm motility, normal morphology, viability, acrosome integrity and membrane integrity when compared with other supplemented groups and the control. Lipid peroxidation increased as the incorporation of DHA supplementation increased. In conclusion, 3ngmL(-1) concentration of DHA resulted in superior quality of frozen-thawed bull spermatozoa and is suggested as the optimum level of DHA to be added into BioXcell extender.