Displaying publications 1 - 20 of 70 in total

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  1. Marris JW, Ślipiński A
    Zootaxa, 2014;3754:32-58.
    PMID: 24869679 DOI: 10.11646/zootaxa.3754.1.2
    The Pediacus Shuckard fauna of Asia and Australasia is revised. Eighteen species are recorded, described and illustrated from the regions and a key to species is provided. Nine new species are described: Pediacus australis sp. nov. (Australia, Papua New Guinea, Philippines, Thailand), P. carinatus sp. nov. (Indonesia, Malaysia, Thailand), P. fujianensis sp. nov. (China), P. japonicoides sp. nov. (Taiwan); P. leei sp. nov. (Taiwan), P. pendleburyi sp. nov. (Malaysia), P. sinensis sp. nov. (China), P. taiwanensis sp. nov. (Taiwan) and P. thomasi sp. nov. (Taiwan). A checklist of the Pediacus fauna of the world is given, listing a total of 31 species. 
  2. Galinski MR, Barnwell JW
    Trends Parasitol, 2009 May;25(5):200-4.
    PMID: 19345613 DOI: 10.1016/j.pt.2009.02.002
    Four human deaths caused by Plasmodium knowlesi, a simian malaria species, are stimulating a surge of public health interest and clinical vigilance in vulnerable areas of Southeast Asia. We, and other colleagues, emphasize that these cases, identified in Malaysia, are a clear warning that health facilities and clinicians must rethink the diagnosis and treatment of malaria cases presumed to be caused by a less virulent human malaria species, Plasmodium malariae.
  3. Smith DG, McDonough JW, George DA
    Am J Primatol, 2007 Feb;69(2):182-98.
    PMID: 17177314
    An 835 base pair (bp) fragment of mitochondrial DNA (mtDNA) was sequenced to characterize genetic variation within and among 1,053 samples comprising five regional populations each of longtail macaques (Macaca fascicularis) and rhesus macaques (Macaca mulatta), and one sample each of Japanese (M. fuscata) and Taiwanese (M. cyclopis) macaques. The mtDNA haplotypes of longtail macaques clustered in two large highly structured clades (Fas1 and Fas2) of a neighbor-joining tree that were reciprocally monophyletic with respect to those representing rhesus macaques, Japanese macaques, and Taiwanese macaques. Both clades exhibited haplotypes of Indonesian and Malaysian longtail macaques widely dispersed throughout them; however, longtail macaques from Indochina, Philippines, and Mauritius each clustered in a separate well-defined clade together with one or a few Malaysian and/or Indonesian longtail macaques, suggesting origins on the Sunda shelf. Longtail macaques from Malaysia and Indonesia were far more genetically diverse, and those from Mauritius were far less diverse than any other population studied. Nucleotide diversity between mtDNA sequences of longtail macaques from different geographic regions is, in some cases, greater than that between Indian and Chinese rhesus macaques. Approximately equal amounts of genetic diversity are due to differences among animals in the same regional population, different regional populations, and different species. A greater proportion of genetic variance was explained by interspecies differences when Japanese and Taiwanese macaques were regarded as regional populations of rhesus macaques than when they were treated as separate species. Rhesus macaques from China were more closely related to both Taiwanese and Japanese macaques than to their own conspecifics from India.
  4. Armstrong JW, Tang J, Wang S
    J Econ Entomol, 2009 Apr;102(2):522-32.
    PMID: 19449631
    The late-aged egg and third-instar life stages of laboratory-reared Malaysian fruit fly, Bactrocera latifrons (Hendel); Mediterranean fruit fly, Ceratitis capitata (Wiedemann); melon fly, B. cucurbitae Coquillett; and oriental fruit fly, B. dorsalis (Hendel), (Diptera: Tephritidae); and the third instars of wild Mediterranean fruit fly were exposed to thermal treatments. A heating block system was used to determine the thermal death kinetics of the four fruit fly species. Treatments consisted of heating the fruit fly life stages to 44, 46, 48, and 50 degrees C and holding for different times ranging from 0 to 120 min depending on the thermal mortality response and time required to obtain 100% mortality for each species and life stage. The 0.5-order kinetic model had the best fit to the survival ratio for all the treatment temperatures and was used to predict lethal times. The thermal death time (TDT) curves showed a tolerance order of Mediterranean fruit fly eggs < or = third instars at 44, 46, and 50 degrees C, third instars < or = eggs at 48 degrees C, and wild third instars < the laboratory-reared third instars. Comparison between Mediterranean fruit fly third instar thermotolerance from Hawaii and Israel showed that Israel Mediterranean fruit fly was more thermotolerant. A comparison of minimum treatment times at a given temperature required to obtain 100% mortality of laboratory-reared Malaysian, Mediterranean (Hawaii and Israel strains), melon, Mexican, and oriental fruit fly eggs or third instars and wild Mediterranean fruit fly (Hawaii strain) eggs or third instars showed that oriental fruit fly was the most thermotolerant among the third instars, and the difference in heat tolerance between third instars and eggs was negligible at 50 degrees C.
  5. Mohd Zain SN, Sahimin N, Pal P, Lewis JW
    Vet Parasitol, 2013 Sep 23;196(3-4):469-77.
    PMID: 23664711 DOI: 10.1016/j.vetpar.2013.03.030
    The occurrence of macroparasites was studied from 543 stray cats in four urban cities from the west (Kuala Lumpur), east (Kuantan), north (Georgetown) and south (Malacca) of Peninsular Malaysia from May 2007 to August 2010. Five ectoparasites species were recovered namely, Ctenocephalides felis, Felicola subrostratus, Haemaphysalis bispinosa, Heterodoxus spiniger and Lynxacarus radovskyi. Two cats from Georgetown were infested with the dog louse, H. spiniger and this represented the first host record for this species in Malaysia. Up to nine species of helminths were recovered with overall high prevalences of infection of 83% in Kuantan, followed by 75.1% in Kuala Lumpur, 71.6% in Georgetown and 68% in Malacca. The helminth species comprised five nematodes, Toxocara malaysiensis, Toxocara cati, Ancylostoma braziliensis, Ancylostoma ceylanicum, Physaloptera praeputialis, two cestodes Taenia taeniaeformis, Dipylidium caninum and one trematode, Playtnosomum fastosum. The majority of helminths were present in the four study sites except for the absence of P. praeputialis in Kuala Lumpur. The prevalence and abundance of infections were analysed taking intrinsic (host age and sex) and extrinsic (season) factors into consideration. Levels of infection and infestation were mainly influenced by host age and to a lesser extent sex and season, whereas four nematode species exhibited significant interactions within the intestine of the cat host. The potential for transmission of some macroparasite species from stray cats to the human population in urban areas is discussed.
  6. Md Ralib A, Mat Nor MB, Pickering JW
    Nephrology (Carlton), 2017 May;22(5):412-419.
    PMID: 27062515 DOI: 10.1111/nep.12796
    AIM: Sepsis is the leading cause of intensive care unit (ICU) admission. Plasma Neutrophil Gelatinase Associated-Lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI) detection; however, it is also increased with inflammation and few studies have been conducted in non-Caucasian populations and/or in developing economies. Therefore, we evaluated plasma NGAL's diagnostic performance in the presence of sepsis and systemic inflammatory response syndrome (SIRS) in a Malaysian ICU cohort.

    METHODS: This is a prospective observational study on patients with SIRS. Plasma creatinine (pCr) and NGAL were measured on ICU admission. Patients were classified according to the occurrence of AKI and sepsis.

    RESULTS: Of 225 patients recruited, 129 (57%) had sepsis of whom 67 (52%) also had AKI. 96 patients (43%) had non-infectious SIRS, of whom 20 (21%) also had AKI. NGAL concentrations were higher in AKI patients within both the sepsis and non-infectious SIRS cohorts (both P 

  7. Mat-Nor MB, Md Ralib A, Abdulah NZ, Pickering JW
    J Crit Care, 2016 Jun;33:245-51.
    PMID: 26851139 DOI: 10.1016/j.jcrc.2016.01.002
    PURPOSE: The purpose of the study was to quantify the ability of procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate noninfectious systemic inflammatory response syndrome (SIRS) and sepsis and to predict hospital mortality.

    MATERIALS: We recruited consecutively adult patients with SIRS admitted to an intensive care unit. They were divided into sepsis and noninfectious SIRS based on clinical assessment with or without positive cultures. Concentrations of PCT and IL-6 were measured daily over the first 3 days.

    RESULTS: A total of 239 patients were recruited, 164 (68.6%) had sepsis, and 68 (28.5%) died in hospital. The PCT levels were higher in sepsis compared with noninfectious SIRS throughout the 3-day period (P < .0001). On admission, PCT concentration was diagnostic of sepsis (area under the curve of 0.63 [0.55-0.71]), and IL-6 was predictive of mortality, (area under the curve of 0.70 [0.62-0.78]). Peak IL-6 concentration improved the risk assessment of Sequential Organ Failure Assessment (SOFA) score for prediction of mortality among those who went on to die by an average of 5% and who did not die by 2%

    CONCLUSIONS: Procalcitonin measured on intensive care unit admission was diagnostic of sepsis, and IL-6 was predictive of mortality. Addition of IL-6 concentration to SOFA score improved risk assessment for prediction of mortality. Future studies should include clinical indices, for example, SOFA score, for prognostic evaluation of biomarkers.

  8. Yusof MZ, Cherrie JW, Samsuddin N, Semple S
    Ann Work Expo Health, 2022 10 11;66(8):1044-1055.
    PMID: 35661855 DOI: 10.1093/annweh/wxac038
    BACKGROUND: Use of pesticides has been linked to neurobehavioral deficits among exposed workers. In Malaysia, organophosphate and pyrethroid pesticides are commonly used to control mosquito-borne diseases.

    OBJECTIVES: This study aims to assess workers' lifetime occupational pesticide exposure and examine the relationship with neurobehavioral health.

    METHODS: A cross-sectional study was conducted on 158 pesticide-exposed and 176 non-exposed workers. To collect historical exposure and job tasks, a questionnaire and an occupational history interview were used. Pesticide exposure was measured in a subgroup of workers via inhalation and skin contact. The total pesticide intake of each worker was assessed using inhalation and dermal exposure models. CANTAB® computerised neurobehavioral performance assessments were used.

    RESULTS: The participants' mean age was 31 (8) years. Pirimiphos-methyl (median = 0.569 mg/m3, Interquartile range [IQR] = 0.151, 0.574) and permethrin (median = 0.136 mg/m3, IQR = 0.116, 0.157) had the highest measured personal inhalation concentrations during thermal spraying. The estimated total lifetime pesticide intake for exposed workers ranged from 0.006 g to 12800 g (median = 379 g and IQR = 131, 794 g). Dermal exposure was the predominant route of pesticide intake for all workers. Compared to controls, workers with high lifetime pesticide intake had lower Match to Sample Visual (adjusted B = -1.4, 95% Confidence Interval (CI) = -2.6, 0.1), Spatial Recognition Memory (adjusted B = -3.3, 95% CI = -5.8, 0.8), Spatial Span (SSP) (adjusted B = -0.6, 95% CI = -0.9, 0.3) scores. Workers with low pesticide intake performed worse than controls (adjusted B = -0.5, 95% CI = -0.8, -0.2) in the SSP test, but scored higher in the Motor Screening test (adjusted B = 0.9, 95% CI = 0.1, 1.6). Higher Paired Associates Learning test scores were observed among higher (adjusted B = 7.4, 95% CI = 2.3, 12.4) and lower (adjusted B = 8.1, 95% CI = 3, 13.2) pesticide intake groups. There was no significant difference between the Reaction Time and Pattern Recognition Memory tests with lifetime pesticide intake after adjusting for confounders.

    CONCLUSION: Pesticide exposure has been linked to poorer neurobehavioral performance. As dermal exposure accounts for a major fraction of total intake, pesticide prevention should focus on limiting dermal exposure.

  9. Mahyudin NA, Blunt JW, Cole AL, Munro MH
    J Biomed Biotechnol, 2012;2012:894708.
    PMID: 22291452 DOI: 10.1155/2012/894708
    The application of an HPLC bioactivity profiling/microtiter plate technique in conjunction with microprobe NMR instrumentation and access to the AntiMarin database has led to the isolation of a new 1. In this example, 1 was isolated from a cytotoxic fraction of an extract obtained from marine-derived Streptomyces sp. cultured on Starch Casein Agar (SCA) medium. The 1D and 2D (1)H NMR and ESIMS data obtained from 20 μg of compound 1 fully defined the structure. The known 2 was also isolated and readily dereplicated using this approach.
  10. Mohd Zain SN, Behnke JM, Lewis JW
    Parasit Vectors, 2012 Mar 07;5:47.
    PMID: 22397763 DOI: 10.1186/1756-3305-5-47
    BACKGROUND: The prevalence of parasitic infections among commensal animals such as black and brown rats in many tropical countries is high and in comparison with studies on rodents in temperate climates, little is known about the community structure of their parasites. Rodent borne parasites pose threats to human health since people living in close proximity to rodent populations can be exposed to infection.

    METHODS: The helminth community structures of two urban rat populations in Kuala Lumpur, Malaysia were investigated. The rats were from two contrasting sites in the city caught over a period of 21 months in 2000-2002.

    RESULTS: Eleven species of helminth parasites comprising seven nematodes (Heterakis spumosum, Mastophorus muris, Nippostrongylus brasiliensis, Syphacia muris, Pterygodermatites tani/whartoni, Gongylonema neoplasticum, Angiostrongylus malaysiensis), three cestodes (Hymenolepis (Rodentolepis) nana, H. diminuta and Taenia taeniaeformis) and one acanthocephalan (Moniliformis moniliformis) were recovered from 346 Rattus rattus and 104 R. norvegicus from two urban sites, Bangsar and Chow Kit, during 2000-2002. Rattus rattus harboured over 60% of all helminths compared with R. norvegicus, although both host species played a dominant role in the different sites with, for example R. norvegicus at Bangsar and R. rattus at Chow Kit accounting for most of the nematodes. Overall 80% of rats carried at least one species of helminth, with the highest prevalences being shown by H. diminuta (35%), H. spumosum (29.8%) and H. nana (28.4%). Nevertheless, there were marked differences in prevalence rates between sites and hosts. The influence of extrinsic (year, season and site) and intrinsic (species, sex and age) factors affecting infracommunity structure (abundance and prevalence of infection) and measures of component community structure were analyzed.

    CONCLUSIONS: Since at least two species of rat borne helminths in Kuala Lumpur have the potential to infect humans, and these showed high prevalences in the rats, the assessment and regular monitoring of infections carried by wild rodents have important roles to play in public health.

  11. Boubaker S, Goodell JW, Kumar S, Sureka R
    Int Rev Financ Anal, 2023 Jan;85:102458.
    PMID: 36439331 DOI: 10.1016/j.irfa.2022.102458
    COVID-19 has posed unprecedented challenges to global finances because of its unparalleled global scope, with both concomitant shocks as well as the likely altering of risk assessments and forecasts for the foreseeable future. As the effects of COVID-19 on financial markets and institutions have been widely addressed by various literature, we systematically synthesize this literature. Through a comprehensive search process, we extract and review 818 articles. Appling bibliometric methods, we explore the trends among various research constituents involved in the field. Using multi-dimensional scaling, we identify the intellectual structure of research in the domain and outline four distinct themes. We also identify the evolution and shifts in research within the short span of three years since the inception of COVID-19. Through detailed content analysis, various future research directions are proposed.
  12. Ismail I, Gaskin S, Pisaniello D, Edwards JW
    Ind Health, 2018 Apr 07;56(2):166-170.
    PMID: 29199264 DOI: 10.2486/indhealth.2017-0157
    Elbow length PVC gloves are often recommended for protection against organophosphorus pesticide (OP) exposure in agriculture. However, performance may be reduced due to high temperature, UV exposure and abrasion. We sought to assess these impacts for two OPs under normal use and reasonable worst-case scenarios. Glove permeation tests were conducted using ASTM cells with two PVC glove brands at 23°C and 45°C for up to 8 h. Technical grade dichlorvos and formulated diazinon were used undiluted and at application strength. Breakthough of undiluted dichlorvos occurred at both 23°C and 45°C, but only at 45°C for application strength. Breakthrough of diazinon was not achieved, except when undiluted at 45°C. UV-exposed and abraded gloves showed reduced performance, with the effect being approximately two-fold for dichlorvos. Only small differences were noted between glove brands. Extra precautions should be taken when handling concentrated OPs at high temperature, or when using abraded or sunlight-exposed gloves.
  13. Ralib AM, Pickering JW, Shaw GM, Than MP, George PM, Endre ZH
    Crit Care, 2014;18(6):601.
    PMID: 25366893 DOI: 10.1186/s13054-014-0601-2
    INTRODUCTION: Acute Kidney Injury (AKI) biomarker utility depends on sample timing after the onset of renal injury. We compared biomarker performance on arrival in the emergency department (ED) with subsequent performance in the intensive care unit (ICU).
    METHODS: Urinary and plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL), and urinary Cystatin C (CysC), alkaline phosphatase, γ-Glutamyl Transpeptidase (GGT), α- and π-Glutathione S-Transferase (GST), and albumin were measured on ED presentation, and at 0, 4, 8, and 16 hours, and days 2, 4 and 7 in the ICU in patients after cardiac arrest, sustained or profound hypotension or ruptured abdominal aortic aneurysm. AKI was defined as plasma creatinine increase ≥ 26.5 μmol/l within 48 hours or ≥ 50% within 7 days.
    RESULTS: n total, 45 of 77 patients developed AKI. Most AKI patients had elevated urinary NGAL, and plasma NGAL and CysC in the period 6 to 24 hours post presentation. Biomarker performance in the ICU was similar or better than when measured earlier in the ED. Plasma NGAL diagnosed AKI at all sampling times, urinary NGAL, plasma and urinary CysC up to 48 hours, GGT 4 to 12 hours, and π-GST 8 to 12 hours post insult. Thirty-one patients died or required dialysis. Peak 24-hour urinary NGAL and albumin independently predicted 30-day mortality and dialysis; odds ratios 2.87 (1.32 to 6.26), and 2.72 (1.14 to 6.48), respectively. Urinary NGAL improved risk prediction by 11% (IDI event of 0.06 (0.002 to 0.19) and IDI non-event of 0.04 (0.002 to 0.12)).
    CONCLUSION: Early measurement in the ED has utility, but not better AKI diagnostic performance than later ICU measurement. Plasma NGAL diagnosed AKI at all time points. Urinary NGAL best predicted mortality or dialysis compared to other biomarkers.
    TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12610001012066. Registered 12 February 2010.
  14. Guo T, Tsai D, Bai S, Morley JW, Suaning GJ, Lovell NH, et al.
    Crit Rev Biomed Eng, 2014;42(5):419-36.
    PMID: 25745804
    The vertebrate retina is a clearly organized signal-processing system. It contains more than 60 different types of neurons, arranged in three distinct neural layers. Each cell type is believed to serve unique role(s) in encoding visual information. While we now have a relatively good understanding of the constituent cell types in the retina and some general ideas of their connectivity, with few exceptions, how the retinal circuitry performs computation remains poorly understood. Computational modeling has been commonly used to study the retina from the single cell to the network level. In this article, we begin by reviewing retinal modeling strategies and existing models. We then discuss in detail the significance and limitations of these models, and finally, we provide suggestions for the future development of retinal neural modeling.
  15. van der Sar SA, Blunt JW, Cole AL, Din LB, Munro MH
    J Nat Prod, 2005 Dec;68(12):1799-801.
    PMID: 16378381
    A new dichlorinated pulvinic acid derivative, methyl-3',5'-dichloro-4,4'-di-O-methylatromentate, was isolated from the fruiting body of a Scleroderma sp. The structure was determined using spectroscopic methods, and an X-ray analysis was carried out for confirmation of the structure. Compound was found to display moderate antimicrobial activity against Bacillus subtilis.
  16. Benacer D, Zain SNM, Lewis JW, Khalid MKNM, Thong KL
    Rev Soc Bras Med Trop, 2017 Mar-Apr;50(2):239-242.
    PMID: 28562762 DOI: 10.1590/0037-8682-0364-2016
    INTRODUCTION:: This study aimed to develop a duplex endpoint PCR assay for rapid detection and differentiation of Leptospira strains.

    METHODS:: Primers were designed to target the rrs (LG1/LG2) and ligB (LP1/LP2) genes to confirm the presence of the Leptospira genus and the pathogenic species, respectively.

    RESULTS:: The assay showed 100% specificity against 17 Leptospira strains with a limit of detection of 23.1pg/µl of leptospiral DNA and sensitivity of 103 leptospires/ml in both spiked urine and water.

    CONCLUSIONS:: Our duplex endpoint PCR assay is suitable for rapid early detection of Leptospira with high sensitivity and specificity.
  17. Alghamdi SQ, Low VL, Alkathiry HA, Alagaili AN, McGarry JW, Makepeace BL
    Parasit Vectors, 2021 Oct 19;14(1):541.
    PMID: 34666829 DOI: 10.1186/s13071-021-05049-x
    BACKGROUND: The ixodid tick genera Rhipicephalus and Haemaphysalis contain several species of medical and/or veterinary importance, but their diversity in some regions of the world remains under-explored. For instance, very few modern studies have been performed on the taxonomy of these genera on the Arabian Peninsula.

    METHODS: In this study, we trapped small mammals in the 'Asir Mountains of south-western Saudi Arabia and collected tick specimens for morphological examination and molecular barcoding, targeting three mitochondrial loci: cox1, 16S rRNA and 12S rRNA.

    RESULTS: We obtained a total of 733 ticks (608 Haemaphysalis spp. and 125 Rhipicephalus spp.) from 75 small mammal hosts belonging to six species. All tick specimens were immature except for nine adults recovered from a hedgehog (Paraechinus aethiopicus). Morphologically, the Rhipicephalus ticks resembled R. camicasi, but the Haemaphysalis ticks showed differences in palp morphology compared with species previously described from Saudi Arabia. Phylogenetic analysis and automatic barcode gap discovery identified a novel clade of Rhipicephalus sp. representing most of the nymphs. This was most closely related to R. leporis, R. guilhoni and R. linnaei. The adult ticks and a small proportion of nymphs clustered with R. camicasi sequences from a previous study. Finally, the Haemaphysalis nymphs formed two distinct clades that were clearly separated from all reference sequences but closest to some African species.

    CONCLUSIONS: This apparent high level of tick diversity observed in a single study site of only ~ 170 km2, on a relatively small number of hosts, highlights the potential for the discovery of new tick species on the Arabian Peninsula.

  18. Watts MP, Gan HM, Peng LY, Lê Cao KA, Moreau JW
    Environ Sci Technol, 2017 Nov 21;51(22):13353-13362.
    PMID: 29064247 DOI: 10.1021/acs.est.7b04152
    Thiocyanate (SCN-) is a contaminant requiring remediation in gold mine tailings and wastewaters globally. Seepage of SCN--contaminated waters into aquifers can occur from unlined or structurally compromised mine tailings storage facilities. A wide variety of microorganisms are known to be capable of biodegrading SCN-; however, little is known regarding the potential of native microbes for in situ SCN- biodegradation, a remediation option that is less costly than engineered approaches. Here we experimentally characterize the principal biogeochemical barrier to SCN- biodegradation for an autotrophic microbial consortium enriched from mine tailings, to arrive at an environmentally realistic assessment of in situ SCN- biodegradation potential. Upon amendment with phosphate, the consortium completely degraded up to ∼10 mM SCN- to ammonium and sulfate, with some evidence of nitrification of the ammonium to nitrate. Although similarly enriched in known SCN--degrading strains of thiobacilli, this consortium differed in its source (mine tailings) and metabolism (autotrophy) from those of previous studies. Our results provide a proof of concept that phosphate limitation may be the principal barrier to in situ SCN- biodegradation in mine tailing waters and also yield new insights into the microbial ecology of in situ SCN- bioremediation involving autotrophic sulfur-oxidizing bacteria.
  19. Gu Y, Shih STF, Geevasinga N, Chan L, Frew JW, Sebaratnam DF
    JAMA Dermatol, 2024 May 08.
    PMID: 38717780 DOI: 10.1001/jamadermatol.2024.1037
    IMPORTANCE: The HLA-B*15:02 allele has been associated with an increased risk of carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in specific Asian populations (including Han Chinese, Malaysian, Thai, and Vietnamese individuals). While HLA-B*15:02 genotype testing in Asian populations is recommended by several international prescribing guidelines, it is not subsidized by the Medicare Benefits Schedule in Australia.

    OBJECTIVE: To evaluate the cost-effectiveness of HLA-B*15:02 genotyping in Asian Australian patients with epilepsy.

    DESIGN, SETTING, AND PARTICIPANTS: A model with components of decision analysis and Markov simulation was developed to simulate clinical trajectories of adult Asian Australian patients with newly diagnosed epilepsy being considered for carbamazepine treatment. Cost-effectiveness and cost-utility analyses over a lifetime time horizon were conducted from the perspective of the Australian health care sector. The study was conducted in May 2023 and data analysis was performed from August 2023 to November 2023.

    INTERVENTION: No HLA-B*15:02 genotyping and the empirical initiation of treatment with carbamazepine vs HLA-B*15:02 genotyping and the initiation of treatment with valproate in allele carriers.

    MAIN OUTCOMES AND MEASURES: Life-years (LYs), quality-adjusted life-years (QALYs), and costs in 2023 Australian dollars (A$); incremental cost-effectiveness ratios.

    RESULTS: HLA-B*15:02 screening was associated with an additional mean cost of A$114 (95% CI, -A$83 to A$374; US$76; 95% CI, -US$55 to US$248) and a reduction in 0.0152 LYs (95% CI, 0.0045 to 0.0287 LYs) but improvement by 0.00722 QALYs (95% CI, -0.0247 to -0.01210) compared with no screening, resulting in an incremental cost-effectiveness ratio of A$15 839 per QALY gained (US$10 523 per QALY). Therefore, universal genotyping for Asian Australian individuals was cost-effective compared with current standards of practice at the A$50 000 per QALY willingness-to-pay threshold. Sensitivity analyses demonstrated that the intervention remained cost-effective across a range of costs, utilities, transition probabilities, and willingness-to-pay thresholds. At the A$50 000 per QALY willingness-to-pay threshold, universal screening was the preferred strategy in 88.60% of simulations.

    CONCLUSIONS AND RELEVANCE: The results of this economic evaluation suggest that HLA-B*15:02 screening represents a cost-effective choice for Asian Australian patients with epilepsy who are being considered for treatment with carbamazepine.

  20. Nayan N, van Erven G, Kabel MA, Sonnenberg AS, Hendriks WH, Cone JW
    J Sci Food Agric, 2019 Jun;99(8):4054-4062.
    PMID: 30737799 DOI: 10.1002/jsfa.9634
    BACKGROUND: White rot fungi have been used to improve the nutritive value of lignocellulose for ruminants. In feed analysis, the Van Soest method is widely used to determine the cell wall contents. To assess the reliability of this method (Method A) for determination of cell wall contents in fungal-treated wheat straw, we compared a combined monosaccharide analysis and pyrolysis coupled to gas chromatography with mass spectrometry (Py-GC/MS) (Method B). Ruminal digestibility, measured as in vitro gas production (IVGP), was subsequently used to examine which method explains best the effect of fungal pretreatment on the digestibility of wheat straw.

    RESULTS: Both methods differed considerably in the mass recoveries of the individual cell wall components, which changed on how we assess their degradation characteristics. For example, Method B gave a higher degradation of lignin (61.9%), as compared to Method A (33.2%). Method A, however, showed a better correlation of IVGP with the ratio of lignin to total structural carbohydrates, as compared to Method B (Pearson's r of -0.84 versus -0.69). Nevertheless, Method B provides a more accurate quantification of lignin, reflecting its actual modification and degradation. With the information on the lignin structural features, Method B presents a substantial advantage in understanding the underlying mechanisms of lignin breakdown. Both methods, however, could not accurately quantify the cellulose contents - among others, due to interference of fungal biomass.

    CONCLUSION: Method A only accounts for the recalcitrant residue and therefore is more suitable for evaluating ruminal digestibility. Method B allows a more accurate quantification of cell wall, required to understand and better explains the actual modification of the cell wall. The suitability of both methods, therefore, depends on their intended purposes. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

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