Displaying publications 1 - 20 of 28 in total

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  1. Defining and measuring trophic role similarity in food webs using regular equivalence
    Luczkovich JJ, Borgatti SP, Johnson JC, Everett MG
    J Theor Biol, 2003 Feb 07;220(3):303-21.
    PMID: 12468282
    We present a graph theoretic model of analysing food web structure called regular equivalence. Regular equivalence is a method for partitioning the species in a food web into "isotrophic classes" that play the same structural roles, even if they are not directly consuming the same prey or if they do not share the same predators. We contrast regular equivalence models, in which two species are members of the same trophic group if they have trophic links to the same set of other trophic groups, with structural equivalence models, in which species are equivalent if they are connected to the exact same other species. Here, the regular equivalence approach is applied to two published food webs: (1) a topological web (Malaysian pitcher plant insect food web) and (2) a carbon-flow web (St. Marks, Florida seagrass ecosystem food web). Regular equivalence produced a more satisfactory set of classes than did the structural approach, grouping basal taxa with other basal taxa and not with top predators. Regular equivalence models provide a way to mathematically formalize trophic position, trophic group and trophic niche. These models are part of a family of models that includes structural models used extensively by ecologists now. Regular equivalence models uncover similarities in trophic roles at a higher level of organization than do the structural models. The approach outlined is useful for measuring the trophic roles of species in food web models, measuring similarity in trophic relations of two or more species, comparing food webs over time and across geographic regions, and aggregating taxa into trophic groups that reduce the complexity of ecosystem feeding relations without obscuring network relationships. In addition, we hope the approach will prove useful in predicting the outcome of predator-prey interactions in experimental studies.
  2. Fulltext Pilot study of formestane in postmenopausal women with breast cancer
    Joseph JK, Lim AKH
    Med J Malaysia, 1998 Mar;53(1):37-41.
    PMID: 10968135
    A pilot study of Formestane or 4-Hydroxyandrostenedione (Lentaron), a new endocrine agent, was conducted on 18 postmenopausal patients with locally advanced and metastatic breast cancer. 16 patients were evaluable for response and objective responses were seen in 4 patients (25%). Stabilisation of disease was seen in 5 patients (32%). Out of 17 patients evaluable for toxicity, 3 (18%) reported adverse effects including hot flushes, lethargy and myalgia. Adverse effects were mild, transient and no patient required discontinuation of drug. Our study confirms that Formestane is a well tolerated endocrine agent with low toxicity and reasonable efficacy in postmenopausal patients with locally advanced and metastatic breast cancer.
  3. A case of probable sporadic Creutzfeldt-Jacob Disease in a tertiary care hospital in Malaysia
    Mugilan SR, Joseph JP
    Med J Malaysia, 2018 12;73(6):433-435.
    PMID: 30647225
    The diagnosis of Creutzfeldt-Jakob disease (CJD) can be challenging as findings are non-specific and there is low awareness of the disease. We present a case of an 83-yearold man with a two months history of rapidly progressive dementia. After a series of extensive diagnostic examinations, he was diagnosed with probable sporadic CJD with key findings of rapidly progressive dementia, myoclonus, pyramidal signs, abnormal hyperintensity signals on diffusion-weighted magnetic resonance imaging (DW-MRI) and typical electroencephalograph (EEG). His symptoms progressively worsened and he died four months after the onset of symptoms.
  4. Fulltext The predictors of subclinical cerebral infarcts in ischaemic stroke patients
    Hamidon BB, Joseph JP, Raymond AA
    Med J Malaysia, 2007 Jun;62(2):114-6.
    PMID: 18705441
    Subclinical cerebral infarcts (SCI) have been increasingly shown to cause a significant clinical impact. However, there are limited data available on Asian patients. The objectives of this study were to determine the prevalence of SCI in ischaemic stroke patients seen in the Hospital Universiti Kebangsaan Malaysia (HUKM) and to identify its associated risk factors. We evaluated the brain computed tomography (CT) evidence of subclinical infarcts in ischaemic stroke patients. The patients were selected from those who were on regular follow up in the neurology clinic following an ischaemic stroke. The risk factors associated with subclinical infarct were documented. The brain CTs were done during acute admission and reviewed for SCI. Sixty-one patients were enrolled in this study. Twenty-two (36.1%) out of the 61 patients had SCI. The risk factors for SCI in our study were hypertension (OR 14.16 CI 2.04-97.89), diabetes mellitus (OR 12.48; CI 1.95-79.77) and leukoaraiosis (OR 28.39; CI 2.33-284.16). Subclinical cerebral infarcts were present in about one third of our ischaemic stroke patients. This finding is higher than in previous studies done on Caucasians. Hypertension, diabetes mellitus and leukoaraiosis independently predict SCI.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  5. Fulltext Synchronous activity lowers the energetic cost of nest escape for sea turtle hatchlings
    Rusli MU, Booth DT, Joseph J
    J Exp Biol, 2016 05 15;219(Pt 10):1505-13.
    PMID: 27207954 DOI: 10.1242/jeb.134742
    A potential advantage of group movement in animals is increased locomotion efficiency. This implies a reduced energetic cost for individuals that occur in larger groups such as herds, flocks and schools. When chelonian hatchlings hatch in the underground nest with finite energy for their post-hatching dispersal phase, they face the challenge of minimizing energetic expenditure while escaping the nest. The term 'social facilitation' has been used to describe the combined digging effort of sea turtle hatchlings during nest escape. Given that in a normal clutch, a substantial part of the energy reserve within the residual yolk is used by hatchlings in the digging out process, a decreased cohort size may reduce the energy reserve available to cross the beach and sustain the initial swimming frenzy. This hypothesis was experimentally tested by varying cohort size in hatchling green turtles (Chelonia mydas) and measuring energy expenditure during the nest escape process using open-flow respirometry. The energetic cost of escaping through 40 cm of sand was calculated to vary between 4.4 and 28.3 kJ per individual, the cost decreasing as the number of individuals in the cohort increased. This represents 11-68% of the energy contained in a hatchling's residual yolk at hatching. The reduced energetic cost associated with large cohorts resulted from both a lower metabolic rate per individual and a shortened nest escape time. We conclude that synchronous digging activity of many hatchlings during nest escape evolved not only to facilitate rapid nest emergence but also to reduce the energetic cost to individuals.
  6. Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia
    Hor ES, Subramaniam S, Koay JM, Bharathy A, Vasudevan U, Panickulam JJ, et al.
    Australas Psychiatry, 2016 Feb;24(1):67-71.
    PMID: 26400455 DOI: 10.1177/1039856215604484
    OBJECTIVES: To evaluate the monitoring of metabolic parameters among outpatients maintained on antipsychotic medications in a general hospital setting in Malaysia and to assess the impact of a local monitoring protocol.
    METHODS: By performing a baseline audit of files from a random sample of 300 patients prescribed antipsychotic medications for at least 1 year; we determined the frequency of metabolic monitoring. The findings informed the design of a new local protocol, on which clinical staff was briefed. We re-evaluated metabolic monitoring immediately after implementation, in a small sample of new referrals and current patients. We explored staff perceptions of the initiative with a follow-up focus group, 6 months post-implementation.
    RESULTS: The baseline audit revealed a sub-optimal frequency of metabolic parameter recording. Re-audit, following implementation of the new protocol, revealed improved monitoring but persisting deficits. Dialogue with the clinical staff led to further protocol modification, clearer definition of staff roles and use of a standard recording template. Focus group findings revealed positive perceptions of the initiative, but persisting implementation barriers, including cultural issues surrounding waist circumference measurement.
    CONCLUSIONS: Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns.
    KEYWORDS: Malaysia; antipsychotic agents; cultural issues; mental disorders; metabolic monitoring; metabolic syndrome; patient monitoring; staff behaviour; waist circumference
    Study site: Psychiatric clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia
  7. Fulltext Comparative Transcriptomic and Molecular Pathway Analyses of HL-CZ Human Pro-Monocytic Cells Expressing SARS-CoV-2 Spike S1, S2, NP, NSP15 and NSP16 Genes
    Sharma A, Ong JW, Loke MF, Chua EG, Lee JJ, Choi HW, et al.
    Microorganisms, 2021 May 31;9(6).
    PMID: 34073047 DOI: 10.3390/microorganisms9061193
    The ongoing COVID-19 pandemic is a clear and present threat to global public health. Research into how the causative SARS-CoV-2 virus together with its individual constituent genes and proteins interact with target host cells can facilitate the development of improved strategies to manage the acute and long-term complications of COVID-19. In this study, to better understand the biological roles of critical SARS-CoV-2 proteins, we determined and compared the host transcriptomic responses of the HL-CZ human pro-monocytic cell line upon transfection with key viral genes encoding the spike S1 subunit, S2 subunit, nucleocapsid protein (NP), NSP15 (endoribonuclease), and NSP16 (2'-O-ribose-methyltransferase). RNA sequencing followed by gene set enrichment analysis and other bioinformatics tools revealed that host genes associated with topologically incorrect protein, virus receptor activity, heat shock protein binding, endoplasmic reticulum stress, antigen processing and presentation were up-regulated in the presence of viral spike S1 expression. With spike S2 expression, pro-monocytic genes associated with the interferon-gamma-mediated signaling pathway, regulation of phosphatidylinositol 3-kinase activity, adipocytokine signaling pathway, and insulin signaling pathway were down-regulated, whereas those associated with cytokine-mediated signaling were up-regulated. The expression of NSP15 induced the up-regulation of genes associated with neutrophil degranulation, neutrophil-mediated immunity, oxidative phosphorylation, prion disease, and pathways of neurodegeneration. The expression of NSP16 resulted in the down-regulation of genes associated with S-adenosylmethionine-dependent methyltransferase activity. The expression of NP down-regulated genes associated with positive regulation of neurogenesis, nervous system development, and heart development. Taken together, the complex transcriptomic alterations arising from these viral-host gene interactions offer useful insights into host genes and their pathways that potentially contribute to SARS-CoV-2 pathogenesis.
  8. Genetics of inflammatory bowel disease in Asia: systematic review and meta-analysis
    Ng SC, Tsoi KK, Kamm MA, Xia B, Wu J, Chan FK, et al.
    Inflamm Bowel Dis, 2012 Jun;18(6):1164-76.
    PMID: 21887729 DOI: 10.1002/ibd.21845
    BACKGROUND: Inflammatory bowel diseases (IBD) result from an interaction between genetic and environmental factors. Preliminary findings suggest that susceptibility genes differ between IBD patients in Asia and the West. We aimed to evaluate disease-predisposing genes in Asian IBD patients.

    METHODS: A systematic review and meta-analysis were performed of published studies from 1950 to 2010 using keyword searches in MEDLINE, EMBASE, EBM Reviews, and BIOSIS Previews.

    RESULTS: In all, 477 abstracts were identified and data extracted from 93 studies, comprising 17,976 IBD patients and 27,350 age- and sex-matched controls. Major nucleotide oligomerization domain (NOD)-2 variants in Western Crohn's disease (CD) patients were not associated with CD in Han Chinese, Japanese, South Korean, Indian, and Malaysian populations. New NOD2 mutations were, however, associated with CD in Malaysians (JW1), Han Chinese, and Indians (P268S). Autophagy-related protein 16-linked 1 (ATG16L1) was not associated with CD in East Asians (odds ratio [OR] 0.97; 95% confidence interval [CI] 0.84-1.13). Interleukin (IL)-23R was associated with CD in South Koreans (OR 1.8; 95% CI 1.16-2.82) and a single nucleotide polymorphism in IL-23R (Gly149Arg) was protective of CD in Han Chinese (OR 0.3; 95% CI 0.15-0.60). Tumor necrosis factor (TNF) superfamily gene-15 (SF15) polymorphisms were associated with CD (OR 2.68; 95% CI 1.86-3.86), while TNF-308 polymorphisms (OR 1.82; 95% CI 1.15-2.9), cytotoxic T lymphocyte antigen (CTLA)-4 (OR 2.75; 95% CI 1.22-6.22) and MICA allele (OR 2.41; 95% CI 1.89-3.07) were associated with ulcerative colitis in Asians.

    CONCLUSIONS: Genetic mutations of IBD in Asians differ from Caucasians. New mutations and susceptibility genes identified in Asian IBD patients provide an opportunity to explore new disease-associated mechanisms in this population of rising incidence.

  9. End compulsory drug treatment in the Asia-Pacific region
    Stoicescu C, Lataire Q, Peters K, Amon JJ, Kamarulzaman A, Ali R, et al.
    Lancet, 2022 01 29;399(10323):419-421.
    PMID: 35032436 DOI: 10.1016/S0140-6736(22)00003-4
  10. Examination Approach to the Dizzy and Swaying Patient
    Said Mogutham NN, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S, Naesarajoo JJJ, et al.
    Malays J Med Sci, 2020 Dec;27(6):89-101.
    PMID: 33447137 DOI: 10.21315/mjms2020.27.6.9
    Background: Dizziness is a common presenting complaint among patients in Malaysia. It is a vague term which could be associated with vertigo, imbalance, ataxia or syncope. In order to deal with this overwhelming complaint, a detailed history-taking is essential in confirming aetiology of disease and this should be followed by a meticulous clinical examination. The purpose of the video manuscript it to provide a step-by-step approach to a dizzy and swaying patient, specially catered for Malaysian medical students and trainees.

    Methods: A series of videos were shot, which involved the eye, ear, vestibular system, cerebellar, proprioceptive sense and gait examination. These videos, conducted in Universiti Sains Malaysia (USM) School of Medical Sciences, will be first in Malaysia and will highlight the proper technique and rapport with patients and essential points of each examination. There will be summary at the end of each examination on how to report findings which is a common weakness among students.

    Conclusion: We hope that students and junior doctors could be apply these methods in their daily assessment of dizzy patients and ultimately, reach an accurate diagnosis.

  11. Fulltext G2677T polymorphism can predict treatment outcome of Malaysians with complex partial seizures being treated with Carbamazepine
    Subenthiran S, Abdullah NR, Muniandy PK, Joseph JP, Cheong KC, Ismail Z, et al.
    Genet. Mol. Res., 2013;12(4):5937-44.
    PMID: 24338387 DOI: 10.4238/2013.November.26.3
    Carbamazepine (CBZ) is used as the first line of treatment of complex partial seizures (CPS) in Malaysia. While this drug is known to be effective for the treatment of CPS, more than 30% of patients remain drug resistant to CBZ mono-therapy. We examined a possible relationship between patients' response to CBZ mono-therapy and the G2677T SNP of the ABCB1 gene. Three hundred and fourteen patients with CPS were recruited from the Neurology Department of the Kuala Lumpur Hospital, of whom 152 were responders and the other 162 were non-responders to CBZ mono-therapy. DNA was extracted from blood samples and real-time PCR was performed to detect the G2677T SNP of the ABCB1 gene. Results were described as genotype frequencies and compared by logistic regression analysis. Among the 152 responders, 74% had the GG genotype. However, among the 162 non-responders, 26.5% had the GT genotype and 39% had the TT genotype. There was a significant difference in genotype frequency (TT vs GG; odds ratio 4.70; 95% confidence interval, 2.70-8.20) between responders and non-responders. The presence of the T allele of the G2677T SNP appears to be a useful screening marker to determine if a patient is going to be resistant to CBZ as a single drug therapy in the treatment of CPS.
  12. Safety and efficacy of rapid dose administration of quetiapine in bipolar mania
    Hatim A, Habil H, Jesjeet SG, Low CC, Joseph J, Jambunathan ST, et al.
    Hum Psychopharmacol, 2006 Jul;21(5):313-8.
    PMID: 16856220
    In this open-label pilot study, 20 adult patients hospitalized for acute bipolar mania received oral quetiapine as a single evening dose of 200 mg on day 1, increased by 200 mg/day on days 2, 3, and 4 until 800 mg/day taken in 2 divided doses on day 4. From day 5 onward, patients received a flexible total dose of 400-800 mg/day until completion of 3 weeks of treatment. Safety and tolerability were assessed by adverse-event (AE)-related dropouts in week 1, incidence of AEs including EPS, changes in electrocardiogram, and vital signs. Efficacy was assessed using the YMRS, PANSS, and CGI scales. Nineteen of 20 patients (95%) completed the quetiapine rapid titration during week 1. Significant improvement was observed in YMRS, PANSS, and CGI Severity of Illness scores by day 5, and was maintained throughout the study. A reduction of > or = 50% in YMRS score was achieved by 75% of patients by day 7, and maintained to day 21. Overall, 20% of patients discontinued due to AEs. Agitation was the most common cause of AE-related study discontinuation. Thirty-five per cent of patients required dose adjustment due to AEs after rapid dose administration was completed. Most patients tolerated rapid titration of quetiapine to 800 mg/day by day 4 of therapy, with a significant improvement in manic symptoms by day 7 of treatment.
  13. Exploring a novel deep eutectic solvents combined with vortex assisted dispersive liquid-liquid microextraction and its toxicity for organophosphorus pesticides analysis from honey and fruit samples
    Elencovan V, Joseph J, Yahaya N, Abdul Samad N, Raoov M, Lim V, et al.
    Food Chem, 2021 Aug 10;368:130835.
    PMID: 34416487 DOI: 10.1016/j.foodchem.2021.130835
    A novel deep eutectic solvents (DES) was successfully applied as an emulsifier in vortex assisted liquid-liquid microextraction (VALLME) coupled with gas chromatography-mass spectrometry for the determination of organophosphorus pesticides in honey and fruit samples. Based on the result of toxicity study, DES provides new opportunities for the safe delivery and application. The predominant parameters affecting extraction efficiency were thoroughly optimized and studied in detail. Under optimum parameters, the calibration curve was determined in the concentration range of 0.1 to 200 µgL-1 with excellent determination coefficients values of 0.9989 to 0.9999. Limit of detection and limit of quantification were found to be 0.01 - 0.09 µgL-1 and 0.03 - 0.2 µgL-1, respectively. Application of the developed method to honey and fruit samples gave acceptable recovery values 83 - 109% with relative standard deviation below than 9.5%. The suggested approach has also proven to be simple, cost-effective, rapid, and non-toxic in nature.
  14. Fulltext In vitro Anticancer Effects of Vernonia amygdalina Leaf Extract and Green-Synthesised Silver Nanoparticles
    Joseph J, Khor KZ, Moses EJ, Lim V, Aziz MY, Abdul Samad N
    Int J Nanomedicine, 2021;16:3599-3612.
    PMID: 34079252 DOI: 10.2147/IJN.S303921
    Purpose: Vernonia amygdalina (VA) is a traditional African herbal medicine that has been reported to possess anticancer properties. However, the anticancer properties of VA silver nanoparticles have not been studied. The aim of the study was to examine and evaluate the anticancer activities of VA leaf extracts and VA silver nanoparticles on the human breast cancer cell line, MCF-7.

    Methods: VA leaves were extracted using sequential extraction assisted with ultrasound using three different solvents: ethanol, 50% ethanol, and deionized water. The silver nanoparticles were synthesised with VA aqueous extract.

    Results: The ethanol extract and VA silver nanoparticles inhibit MCF-7 cell proliferation with an average half-maximal inhibitory concentration (IC50) value of 67µg/mL and 6.11µg/mL, respectively, after 72 hours of treatment. The ethanol extract and VA silver nanoparticles also caused G1 phase cell cycle arrest, induced apoptosis and nuclear fragmentation in MCF-7 cells.

    Conclusion: VA ethanol extracts and VA silver nanoparticles decreased the cell viability in MCF-7 cells in a time and dose-dependent manner by inducing apoptosis and causing DNA damage. Further research is needed to elucidate the mechanism of action of VA leaf extracts and VA silver nanoparticles. This study is the first to report on the anticancer activity of VA silver nanoparticles in MCF-7 cells.

  15. Fulltext Iron-based metal-organic framework: Synthesis, structure and current technologies for water reclamation with deep insight into framework integrity
    Joseph J, Iftekhar S, Srivastava V, Fallah Z, Zare EN, Sillanpää M
    Chemosphere, 2021 Dec;284:131171.
    PMID: 34198064 DOI: 10.1016/j.chemosphere.2021.131171
    Water is a supreme requirement for the existence of life, the contamination from the point and non-point sources are creating a great threat to the water ecosystem. Advance tools and techniques are required to restore the water quality and metal-organic framework (MOFs) with a tunable porous structure, striking physical and chemical properties are an excellent candidate for it. Fe-based MOFs, which developed rapidly in recent years, are foreseen as most promising to overcome the disadvantages of traditional water depolluting practices. Fe-MOFs with low toxicity and preferable stability possess excellent performance potential for almost all water remedying techniques in contrast to other MOF structures, especially visible light photocatalysis, Fenton, and Fenton-like heterogeneous catalysis. Fe-MOFs become essential tool for water treatment due to their high catalytic activity, abundant active site and pollutant-specific adsorption. However, the structural degradation under external chemical, photolytic, mechanical, and thermal stimuli is impeding Fe-MOFs from further improvement in activity and their commercialization. Understanding the shortcomings of structural integrity is crucial for large-scale synthesis and commercial implementation of Fe-MOFs-based water treatment techniques. Herein we summarize the synthesis, structure and recent advancements in water remediation methods using Fe-MOFs in particular more attention is paid for adsorption, heterogeneous catalysis and photocatalysis with clear insight into the mechanisms involved. For ease of analysis, the pollutants have been classified into two major classes; inorganic pollutants and organic pollutants. In this review, we present for the first time a detailed insight into the challenges in employing Fe-MOFs for water remediation due to structural instability.
  16. Fulltext Health status and genetic compositions of green turtles (Chelonia mydas) foraging in Brunei Bay
    Joseph J, Nishizawa H, Jalimin SN, Othman R, Jaaman SA, Bali J, et al.
    PLoS One, 2023;18(11):e0293979.
    PMID: 37943882 DOI: 10.1371/journal.pone.0293979
    Long-term monitoring of sea turtle aggregations is critical for understanding the impacts of environmental changes on their population health and habitat suitability. Brunei Bay is a significant foraging ground for green turtles in the South China Sea. We analyzed the body size, hematology and body condition of green turtles for their health status in their foraging ground in Brunei Bay over a period of nine years (2011-2019). Additionally, we used mitochondrial DNA (mtDNA) to evaluate changes in the size and genetic composition of green turtle aggregations. Our findings revealed that the size composition of the green turtle population varied seasonally, but there were no significant temporal changes in genetic and size compositions. Hematology parameters and Fulton's body condition index were consistent with those reported for apparently healthy green turtles. Furthermore, we found that blood reference intervals indicated the turtles were healthy. These results provide valuable baseline data for future comparisons with other foraging aggregations and for long-term monitoring of green turtles in Brunei Bay.
  17. A Risk-Scoring System Combined With a Fecal Immunochemical Test Is Effective in Screening High-Risk Subjects for Early Colonoscopy to Detect Advanced Colorectal Neoplasms
    Chiu HM, Ching JY, Wu KC, Rerknimitr R, Li J, Wu DC, et al.
    Gastroenterology, 2016 Mar;150(3):617-625.e3.
    PMID: 26627608 DOI: 10.1053/j.gastro.2015.11.042
    BACKGROUND & AIMS: Age, sex, smoking, and family history are risk factors for colorectal cancer in Asia. The Asia-Pacific Colorectal Screening (APCS) scoring system was developed to identify subjects with a high risk for advanced neoplasm (AN). We tested an algorithm that combined APCS scores with fecal immunochemical test (FIT) in colorectal cancer screening.
    METHODS: We performed a multicenter prospective study, enrolling asymptomatic individuals older than 40 years old in 12 Asia-Pacific regions from December 2011 to December 2013. APCS scores were calculated for each individual (0-1 = low risk [LR], 2-3 = medium risk [MR], and 4-7 = high risk [HR] for AN). LR and MR subjects were offered FIT and referred for early colonoscopies if FIT results were positive. HR subjects were offered colonoscopies. The proportions of subjects with ANs were determined for each group based on colonoscopy findings; odd ratios for LR and MR subjects were calculated compared to LR individuals. We calculated the sensitivity of the APCS-FIT algorithm in identifying subjects with AN.
    RESULTS: A total of 5657 subjects were recruited: 646 subjects (11.4%) were considered LR, 3243 subjects (57.3%) were considered MR, and 1768 subjects (31.3%) were considered HR for AN. The proportions of individuals with an AN in these groups were 1.5%, 5.1%, and 10.9%, respectively. Compared with LR group, MR and HR subjects had a 3.4-fold increase and a 7.8-fold increase in risk for AN, respectively. A total of 70.6% subjects with AN (95% confidence interval: 65.6%-75.1%) and 95.1% subjects with invasive cancers (95% confidence interval: 82.2%-99.2%) were correctly instructed to undergo early colonoscopy examination.
    CONCLUSIONS: The APCS scoring system, which is based on age, sex, family history, and smoking, is a useful tool for determining risk for colorectal cancer and advanced adenoma in asymptomatic subjects. Use of the APCS score-based algorithm in triaging subjects for FIT or colonoscopy can substantially reduce colonoscopy workload.
  18. Development and Validation of the Asia-Pacific Proximal Colon Neoplasia Risk Score
    Wong MCS, Rerknimitr R, Lee Goh K, Matsuda T, Kim HS, Wu DC, et al.
    Clin Gastroenterol Hepatol, 2021 01;19(1):119-127.e1.
    PMID: 31923642 DOI: 10.1016/j.cgh.2019.12.031
    BACKGROUND & AIMS: Patients found to be at high risk of advanced proximal neoplasia (APN) after flexible sigmoidoscopy screening should be considered for colonoscopy examination. We developed and validated a scoring system to identify persons at risk for APN.

    METHODS: We collected data from 7954 asymptomatic subjects (age, 50-75 y) who received screening colonoscopy examinations at 14 sites in Asia. We randomly assigned 5303 subjects to the derivation cohort and the remaining 2651 to the validation cohort. We collected data from the derivation cohort on age, sex, family history of colorectal cancer, smoking, drinking, body mass index, medical conditions, and use of nonsteroidal anti-inflammatory drugs or aspirin. Associations between the colonoscopic findings of APN and each risk factor were examined using the Pearson χ2 test, and we assigned each participant a risk score (0-15), with scores of 0 to 3 as average risk and scores of 4 or higher as high risk. The scoring system was tested in the validation cohort. We used the Cochran-Armitage test of trend to compare the prevalence of APN among subjects in each group.

    RESULTS: In the validation cohort, 79.5% of patients were classified as average risk and 20.5% were classified as high risk. The prevalence of APN in the average-risk group was 1.9% and in the high-risk group was 9.4% (adjusted relative risk, 5.08; 95% CI, 3.38-7.62; P < .001). The score included age (61-70 y, 3; ≥70 y, 4), smoking habits (current/past, 2), family history of colorectal cancer (present in a first-degree relative, 2), and the presence of neoplasia in the distal colorectum (nonadvanced adenoma 5-9 mm, 2; advanced neoplasia, 7). The c-statistic of the score was 0.74 (95% CI, 0.68-0.79), and for distal findings alone was 0.67 (95% CI, 0.60-0.74). The Hosmer-Lemeshow goodness-of-fit test statistic was greater than 0.05, indicating the reliability of the validation set. The number needed to refer was 11 (95% CI, 10-13), and the number needed to screen was 15 (95% CI, 12-17).

    CONCLUSIONS: We developed and validated a scoring system to identify persons at risk for APN. Screening participants who undergo flexible sigmoidoscopy screening with a score of 4 points or higher should undergo colonoscopy evaluation.

  19. Fulltext Effective decellularisation of human saphenous veins for biocompatible arterial tissue engineering applications: Bench optimisation and feasibility in vivo testing
    Sulaiman NS, Bond AR, Bruno VD, Joseph J, Johnson JL, Suleiman MS, et al.
    J Tissue Eng, 2021;12:2041731420987529.
    PMID: 33854749 DOI: 10.1177/2041731420987529
    Human saphenous vein (hSV) and synthetic grafts are commonly used conduits in vascular grafting, despite high failure rates. Decellularising hSVs (D-hSVs) to produce vascular scaffolds might be an effective alternative. We assessed the effectiveness of a detergent-based method using 0% to 1% sodium dodecyl sulphate (SDS) to decellularise hSV. Decellularisation effectiveness was measured in vitro by nuclear counting, DNA content, residual cell viability, extracellular matrix integrity and mechanical strength. Cytotoxicity was assessed on human and porcine cells. The most effective SDS concentration was used to prepare D-hSV grafts that underwent preliminary in vivo testing using a porcine carotid artery replacement model. Effective decellularisation was achieved with 0.01% SDS, and D-hSVs were biocompatible after seeding. In vivo xeno-transplantation confirmed excellent mechanical strength and biocompatibility with recruitment of host cells without mechanical failure, and a 50% patency rate at 4-weeks. We have developed a simple biocompatible methodology to effectively decellularise hSVs. This could enhance vascular tissue engineering toward future clinical applications.
  20. Optimised neem oil-bilayer tablets: A safe, effective and stable tool for the prevention of vector-borne disease outbreaks by Aedes albopictus
    Swathy KK, Sarath Chandran C, Mukundan M, Sreejith KR, Sourav K, Jafna MC, et al.
    Exp Parasitol, 2023 Aug;251:108550.
    PMID: 37230323 DOI: 10.1016/j.exppara.2023.108550
    The control of mosquito breeding is an essential step towards the reduction of vector-borne disease outbreaks. Synthetic larvicidal agents produce resistance in vectors and cause safety concerns in humans, animals and aquatic species. The drawback of synthetic larvicides opened a new avenue for natural larvicidal agents, but poor dosage accuracy, need for frequent applications, low stability and sustainability are the major challenges with them. Hence, this investigation aimed to overcome those drawbacks by developing bilayer tablets loaded with neem oil to prevent mosquito breeding in stagnant water. The optimised batch of neem oil-bilayer tablets (ONBT) had 65%w/w hydroxypropyl methylcellulose K100M and 80%w/w ethylcellulose in its composition. After the completion of 4th week, 91.98 ± 0.871% azadirachtin was released from the ONBT, which was followed by a subsequent drop in the in vitro release. ONBT reported long-term larvicidal efficacy (>75%) and a good deterrent effect which was better than neem oil-based marketed products. The acute toxicity study on a non-target fish model (Poecilia reticulata), OECD Test No.203 confirmed the safety of the ONBT on non-target aquatic species. The accelerated stability studies predicted a good stability profile for the ONBT. The neem oil-based bilayer tablets can be used as an effective tool for the control of vector-borne diseases in society. The product may be a safe, effective and eco-friendly replacement for the existing synthetic as well as natural products in the market.
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