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Fulltext Neck of Femur Fracture in Young Patients With End-Stage Renal Disease and Hyperparathyroidism: A Report of Three Cases and Proposed Treatment Algorithm

Raj JJ, Kow RY, Ramalingam S, Low CL

Cureus, 2021 Jul;13(7):e16155.
PMID: 34367767 DOI: 10.7759/cureus.16155

Secondary hyperparathyroidism is a complication arising from untreated end-stage renal disease (ESRD). It can invariably lead to osteoporosis and subsequently cause pathological neck of femur (NOF) fracture. Despite being young, osteosynthesis in neck of femur fractures of these patients often leads to nonunion and implant failure due to severely osteoporotic bone. We present our experience in managing three young patients with ESRD and secondary hyperthyroidism who sustained NOF fractures. All three patients were successfully treated and showed no complication at one year post-operation. Based on our experience and literature review, we propose a simple algorithm to guide the management of these patients.
Ethnic disparities in trauma mortality outcomes

Leow JJ, Lim VW, Lingam P, Go KT, Teo LT

World J Surg, 2014 Jul;38(7):1694-8.
PMID: 24510246 DOI: 10.1007/s00268-014-2459-5

Ethnic disparities in trauma mortality outcomes have been demonstrated in the United States according to the US National Trauma Data Bank. The aim of this study was to determine the effect of race/ethnicity on trauma mortality in Singapore.
Fulltext Characterisation of a second gain of function EDAR variant, encoding EDAR380R, in East Asia

Riddell J, Basu Mallick C, Jacobs GS, Schoenebeck JJ, Headon DJ

Eur J Hum Genet, 2020 12;28(12):1694-1702.
PMID: 32499598 DOI: 10.1038/s41431-020-0660-6

Ectodysplasin A1 receptor (EDAR) is a TNF receptor family member with roles in the development and growth of hair, teeth and glands. A derived allele of EDAR, single-nucleotide variant rs3827760, encodes EDAR:p.(Val370Ala), a receptor with more potent signalling effects than the ancestral EDAR370Val. This allele of rs3827760 is at very high frequency in modern East Asian and Native American populations as a result of ancient positive selection and has been associated with straighter, thicker hair fibres, alteration of tooth and ear shape, reduced chin protrusion and increased fingertip sweat gland density. Here we report the characterisation of another SNV in EDAR, rs146567337, encoding EDAR:p.(Ser380Arg). The derived allele of this SNV is at its highest global frequency, of up to 5%, in populations of southern China, Vietnam, the Philippines, Malaysia and Indonesia. Using haplotype analyses, we find that the rs3827760 and rs146567337 SNVs arose on distinct haplotypes and that rs146567337 does not show the same signs of positive selection as rs3827760. From functional studies in cultured cells, we find that EDAR:p.(Ser380Arg) displays increased EDAR signalling output, at a similar level to that of EDAR:p.(Val370Ala). The existence of a second SNV with partly overlapping geographic distribution, the same in vitro functional effect and similar evolutionary age as the derived allele of rs3827760, but of independent origin and not exhibiting the same signs of strong selection, suggests a northern focus of positive selection on EDAR function in East Asia.
Downsizing and minimising medialisation of the acetabular component: Novel technique to preserve bone in THA

Raj JJ, Thompson M, Whitehouse SL, Jaiprakash A, Varughese I, Crawford RW

Proc Inst Mech Eng H, 2023 Mar;237(3):368-374.
PMID: 36734414 DOI: 10.1177/09544119231152351

Standard practice for acetabular component placement in total hip arthroplasty (THA) is to medialise the acetabular component. Bone preservation techniques during primary THA are beneficial for possible future revisions. The goal of this study is to examine the effect of downsizing and minimising medialisation of the acetabular component on bone resection volume. The volume of bone resected during acetabular preparation for different sizes of components was calculated and the volume of bone preserved by downsizing the cup was determined. Minimising medialisation of the acetabular component by 1-3 mm from the true floor was calculated. Absolute values and percentage of bone volume preserved when acetabular components are downsized or less medialised is presented. Downsizing the acetabular component by one size (2 mm) preserves between 2.6 cm3 (size 40 vs 42) and 8.4 cm3 (size 72 vs 74) of bone volume and consistently reduces resected bone volume by at least 35% (range 35.2%-37.5%). Similarly, reducing medialisation of a 56 mm acetabular cup (as an example of a commonly implanted component) by 3 mm reduces bone loss by 5.9 cm3- 44% less bone volume resection. Downsizing and minimising medialisation of the cup in THA substantially preserves bone which may benefit future revision surgeries. Surgeons could consider implanting the smallest acceptable acetabular shell to preserve bone without compromising on head size.
Predicting the risk of exacerbation in patients with chronic obstructive pulmonary disease using home telehealth measurement data

Mohktar MS, Redmond SJ, Antoniades NC, Rochford PD, Pretto JJ, Basilakis J, et al.

Artif Intell Med, 2015 Jan;63(1):51-9.
PMID: 25704112 DOI: 10.1016/j.artmed.2014.12.003

BACKGROUND: The use of telehealth technologies to remotely monitor patients suffering chronic diseases may enable preemptive treatment of worsening health conditions before a significant deterioration in the subject's health status occurs, requiring hospital admission.
OBJECTIVE: The objective of this study was to develop and validate a classification algorithm for the early identification of patients, with a background of chronic obstructive pulmonary disease (COPD), who appear to be at high risk of an imminent exacerbation event. The algorithm attempts to predict the patient's condition one day in advance, based on a comparison of their current physiological measurements against the distribution of their measurements over the previous month.
METHOD: The proposed algorithm, which uses a classification and regression tree (CART), has been validated using telehealth measurement data recorded from patients with moderate/severe COPD living at home. The data were collected from February 2007 to January 2008, using a telehealth home monitoring unit.
RESULTS: The CART algorithm can classify home telehealth measurement data into either a 'low risk' or 'high risk' category with 71.8% accuracy, 80.4% specificity and 61.1% sensitivity. The algorithm was able to detect a 'high risk' condition one day prior to patients actually being observed as having a worsening in their COPD condition, as defined by symptom and medication records.
CONCLUSION: The CART analyses have shown that features extracted from three types of physiological measurements; forced expiratory volume in 1s (FEV1), arterial oxygen saturation (SPO2) and weight have the most predictive power in stratifying the patients condition. This CART algorithm for early detection could trigger the initiation of timely treatment, thereby potentially reducing exacerbation severity and recovery time and improving the patient's health. This study highlights the potential usefulness of automated analysis of home telehealth data in the early detection of exacerbation events among COPD patients.
Fulltext Social Media in the Urology Practice | Opinion: NO

Da Silva RD, Leow JJ, Abidin ZA, Linden-Castro E, Castro EIB, Blanco LT, et al.

Int Braz J Urol, 2019 10 19;45(5):882-888.
PMID: 31626517 DOI: 10.1590/S1677-5538.IBJU.2019.05.04
Fulltext A new record of Bengalia emarginata Malloch, 1927 (Diptera: Calliphoridae) from Malaysia

Heo CC, Kurahashi H, Mohamad AM, Jeffrey J, Dhang CC, Zuha RM, et al.

Trop Biomed, 2008 Dec;25(3):262-3.
PMID: 19287369

During a forensic entomological study conducted at an oil palm plantation in Tanjung Sepat, Kuala Langat, Selangor, a Bengalia emarginata Malloch, 1927 (Diptera: Calliphoridae: Calliphorinae: Bengalini) was collected for the first time. Two adults were collected nearby the pig carcass by the first author and identified by the second. Prior to this finding, nine species of Bengalia were recorded from peninsular Malaysia or Borneo. Male of B. emarginata are different from Bengalia varicolor Fabricious by the following characters: Sternite 5 projection rounded with small identation and mid tibia double-fringed in ventral surface.
Fulltext A new record of Fannia prisca Stein, 1918 (Diptera:Fanniidae) from peninsular Malaysia

Heo CC, Kurahashi H, Nishida K, Tan Siew H, Mohamed Z, Mohamed AM, et al.

Trop Biomed, 2008 Dec;25(3):254-6.
PMID: 19287366

Fannia prisca Stein, 1918 is newly recorded from peninsular Malaysia. This record is based on 4 male specimens from Mount Berembun, Brinchang, Cameron Highland, Pahang state, peninsular Malaysia. It is previously recorded from China, Mongolia, Korea, Japan, Taiwan, Bonin Island, Thailand and oriental region. The male of Fannia prisca can be differentiated from male Fannia scalaris by the following features: for F. prisca, mid-coxa without spine; mid-tibia normal or without stout triangular ventral projection; and hind tibia usually with 2 av, while F. scalaris has several stout hook-like spines on the anterior margin; mid-tibia with stout triangular ventral projection and hind tibia usually with 3 av. Both F. prisca and F. scalaris can be differentiated from Fannia leucosticta by looking at its hind tibia, which only has 1 av.
Robust dengue virus infection in bat cells and limited innate immune responses coupled with positive serology from bats in IndoMalaya and Australasia

Irving AT, Rozario P, Kong PS, Luko K, Gorman JJ, Hastie ML, et al.

Cell Mol Life Sci, 2020 Apr;77(8):1607-1622.
PMID: 31352533 DOI: 10.1007/s00018-019-03242-x

Natural reservoir hosts can sustain infection of pathogens without succumbing to overt disease. Multiple bat species host a plethora of viruses, pathogenic to other mammals, without clinical symptoms. Here, we detail infection of bat primary cells, immune cells, and cell lines with Dengue virus. While antibodies and viral RNA were previously detected in wild bats, their ability to sustain infection is not conclusive. Old-world fruitbat cells can be infected, producing high titres of virus with limited cellular responses. In addition, there is minimal interferon (IFN) response in cells infected with MOIs leading to dengue production. The ability to support in vitro replication/production raises the possibility of bats as a transient host in the life cycle of dengue or similar flaviviruses. New antibody serology evidence from Asia/Pacific highlights the previous exposure and raises awareness that bats may be involved in flavivirus dynamics and infection of other hosts.
Fulltext Delayed surgery for localised and metastatic renal cell carcinoma: a systematic review and meta-analysis for the COVID-19 pandemic

Chan VW, Tan WS, Leow JJ, Tan WP, Ong WLK, Chiu PK, et al.

World J Urol, 2021 Dec;39(12):4295-4303.
PMID: 34031748 DOI: 10.1007/s00345-021-03734-1

PURPOSE: The COVID-19 pandemic has led to the cancellation or deferment of many elective cancer surgeries. We performed a systematic review on the oncological effects of delayed surgery for patients with localised or metastatic renal cell carcinoma (RCC) in the targeted therapy (TT) era.
METHOD: The protocol of this review is registered on PROSPERO(CRD42020190882). A comprehensive literature search was performed on Medline, Embase and Cochrane CENTRAL using MeSH terms and keywords for randomised controlled trials and observational studies on the topic. Risks of biases were assessed using the Cochrane RoB tool and the Newcastle-Ottawa Scale. For localised RCC, immediate surgery [including partial nephrectomy (PN) and radical nephrectomy (RN)] and delayed surgery [including active surveillance (AS) and delayed intervention (DI)] were compared. For metastatic RCC, upfront versus deferred cytoreductive nephrectomy (CN) were compared.
RESULTS: Eleven studies were included for quantitative analysis. Delayed surgery was significantly associated with worse cancer-specific survival (HR 1.67, 95% CI 1.23-2.27, p
Fulltext Australian vegetated coastal ecosystems as global hotspots for climate change mitigation

Serrano O, Lovelock CE, B Atwood T, Macreadie PI, Canto R, Phinn S, et al.

Nat Commun, 2019 10 02;10(1):4313.
PMID: 31575872 DOI: 10.1038/s41467-019-12176-8

Policies aiming to preserve vegetated coastal ecosystems (VCE; tidal marshes, mangroves and seagrasses) to mitigate greenhouse gas emissions require national assessments of blue carbon resources. Here, we present organic carbon (C) storage in VCE across Australian climate regions and estimate potential annual CO2 emission benefits of VCE conservation and restoration. Australia contributes 5-11% of the C stored in VCE globally (70-185 Tg C in aboveground biomass, and 1,055-1,540 Tg C in the upper 1 m of soils). Potential CO2 emissions from current VCE losses are estimated at 2.1-3.1 Tg CO2-e yr-1, increasing annual CO2 emissions from land use change in Australia by 12-21%. This assessment, the most comprehensive for any nation to-date, demonstrates the potential of conservation and restoration of VCE to underpin national policy development for reducing greenhouse gas emissions.
Environmental and anthropogenic factors synergistically affect space use of jaguars

Thompson JJ, Morato RG, Niebuhr BB, Alegre VB, Oshima JEF, de Barros AE, et al.

Curr Biol, 2021 Aug 09;31(15):3457-3466.e4.
PMID: 34237270 DOI: 10.1016/j.cub.2021.06.029

Large terrestrial carnivores have undergone some of the largest population declines and range reductions of any species, which is of concern as they can have large effects on ecosystem dynamics and function.1-4 The jaguar (Panthera onca) is the apex predator throughout the majority of the Neotropics; however, its distribution has been reduced by >50% and it survives in increasingly isolated populations.5 Consequently, the range-wide management of the jaguar depends upon maintaining core populations connected through multi-national, transboundary cooperation, which requires understanding the movement ecology and space use of jaguars throughout their range.6-8 Using GPS telemetry data for 111 jaguars from 13 ecoregions within the four biomes that constitute the majority of jaguar habitat, we examined the landscape-level environmental and anthropogenic factors related to jaguar home range size and movement parameters. Home range size decreased with increasing net productivity and forest cover and increased with increasing road density. Speed decreased with increasing forest cover with no sexual differences, while males had more directional movements, but tortuosity in movements was not related to any landscape factors. We demonstrated a synergistic relationship between landscape-scale environmental and anthropogenic factors and jaguars' spatial needs, which has applications to the conservation strategy for the species throughout the Neotropics. Using large-scale collaboration, we overcame limitations from small sample sizes typical in large carnivore research to provide a mechanism to evaluate habitat quality for jaguars and an inferential modeling framework adaptable to the conservation of other large terrestrial carnivores.
Fulltext Phylogenomic Analysis of a 55.1-kb 19-Gene Dataset Resolves a Monophyletic Fusarium that Includes the Fusarium solani Species Complex

Geiser DM, Al-Hatmi AMS, Aoki T, Arie T, Balmas V, Barnes I, et al.

Phytopathology, 2021 Jul;111(7):1064-1079.
PMID: 33200960 DOI: 10.1094/PHYTO-08-20-0330-LE

Scientific communication is facilitated by a data-driven, scientifically sound taxonomy that considers the end-user's needs and established successful practice. In 2013, the Fusarium community voiced near unanimous support for a concept of Fusarium that represented a clade comprising all agriculturally and clinically important Fusarium species, including the F. solani species complex (FSSC). Subsequently, this concept was challenged in 2015 by one research group who proposed dividing the genus Fusarium into seven genera, including the FSSC described as members of the genus Neocosmospora, with subsequent justification in 2018 based on claims that the 2013 concept of Fusarium is polyphyletic. Here, we test this claim and provide a phylogeny based on exonic nucleotide sequences of 19 orthologous protein-coding genes that strongly support the monophyly of Fusarium including the FSSC. We reassert the practical and scientific argument in support of a genus Fusarium that includes the FSSC and several other basal lineages, consistent with the longstanding use of this name among plant pathologists, medical mycologists, quarantine officials, regulatory agencies, students, and researchers with a stake in its taxonomy. In recognition of this monophyly, 40 species described as genus Neocosmospora were recombined in genus Fusarium, and nine others were renamed Fusarium. Here the global Fusarium community voices strong support for the inclusion of the FSSC in Fusarium, as it remains the best scientific, nomenclatural, and practical taxonomic option available.

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