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Fulltext A Rare Cause of Chronic Flexor Tenosynovitis of the Finger

Sem SH, Chen Kang W

Cureus, 2023 Jun;15(6):e40175.
PMID: 37431353 DOI: 10.7759/cureus.40175

Cat scratch disease (CSD) is an uncommon condition. When a patient is infected, the disease is often self-limiting. Cat scratch disease involving the musculoskeletal system had been described, but the manifestation of the disease in hand remained unexplored. We report a case of chronic flexor tenosynovitis of the left index finger caused by cat scratch disease. In this case, the antibiotic treatment did not improve the clinical outcome. However, surgical debridement of the diseased finger resulted in a tremendous improvement in terms of pain and range of motion.
Modeling the spatio-temporal dynamics of air pollution index based on spatial Markov chain model

Alyousifi Y, Ibrahim K, Kang W, Zin WZW

Environ Monit Assess, 2020 Oct 21;192(11):719.
PMID: 33083907 DOI: 10.1007/s10661-020-08666-8

An environmental problem which is of concern across the globe nowadays is air pollution. The extent of air pollution is often studied based on data on the observed level of air pollution. Although the analysis of air pollution data that is available in the literature is numerous, studies on the dynamics of air pollution with the allowance for spatial interaction effects through the use of the Markov chain model are very limited. Accordingly, this study aims to explore the potential impact of spatial dependence over time and space on the distribution of air pollution based on the spatial Markov chain (SMC) model using the longitudinal air pollution index (API) data. This SMC model is pertinent to be applied since the daily data of API from 2012 to 2014 that have been gathered from 37 different air quality stations in Peninsular Malaysia is found to exhibit the property of spatial autocorrelation. Based on the spatial transition probability matrices found from the SMC model, specific characteristics of air pollution are studied in the regional context. These characteristics are the long-run proportion and the mean first passage time for each state of air pollution. It is found that the probability for a particular station's state to remain good is 0.814 if its neighbors are in a good state of air pollution and 0.7082 if its neighbors are in a moderate state. For a particular station having neighbors in a good state of air pollution, the proportion of time for it to continue being in a good state is 0.6. This proportion reduces to 0.4, 0.01, and 0 for the cell of moderate, unhealthy, and very unhealthy states, respectively. In addition, there exists a significant spatial dependence of API, indicating that air pollution for a particular station is dependent on the states of the neighboring stations.
Correction to: Modeling the spatio-temporal dynamics of air pollution index based on spatial Markov chain model

Alyousifi Y, Ibrahim K, Kang W, Zin WZW

Environ Monit Assess, 2020 Nov 08;192(12):753.
PMID: 33164139 DOI: 10.1007/s10661-020-08720-5

The original version of this article unfortunately contained an error in the affiliation section and in the main body text.
Influence of sodium chloride treatment and polysaccharides as debittering agent on the physicochemical properties, antioxidant capacity and sensory characteristics of bitter gourd (Momordica charantia) juice

Siti Rashima R, Maizura M, Kang WM, Fazilah A, Tan LX

J Food Sci Technol, 2017 Jan;54(1):228-235.
PMID: 28242920 DOI: 10.1007/s13197-016-2454-y

The effects of sodium chloride (NaCl) (3.5%) solution and polysaccharides, such as carboxymethyl cellulose (CMC) (0.1, 0.3 and 0.5%) and gum arabic (5, 10 and 15%), on the physicochemical properties, antioxidant capacity and sensory characteristics of bitter gourd juice were investigated. An increase in the concentration of CMC and gum arabic significantly was observed to increase the lightness (L value) and the viscosity (mPas) of bitter gourd juice at all levels. Increased concentrations of gum arabic significantly increased the total soluble solids. The bitter gourd fruit treated with NaCl solution produced the highest lightness (L value) and scavenging activity of free radical 2,2-diphenyl-1-picrylhydrazyl of bitter gourd juice. Increased concentration of gum arabic up to 15% significantly increased the total phenolic content. The addition of 5% gum arabic effectively reduced the bitterness of the bitter gourd juice. Viscosity of the juice resulted in negative correlation for bitterness.
Fulltext Robust empirical Bayes approach for Markov chain modeling of air pollution index

Alyousifi Y, Ibrahim K, Kang W, Zin WZW

J Environ Health Sci Eng, 2021 Jun;19(1):343-356.
PMID: 34150239 DOI: 10.1007/s40201-020-00607-4

Air pollution is a matter of concern among the public, especially for those living in urban and industrial areas. Markov chain modeling is often used to model the underlying dynamics of air pollution, which involves describing the transition probability of going from one air pollution state to another. Thus, estimating the transition probability matrix for the data of the air pollution index (API) is an essential process in the modeling. However, one may observe many zero probabilities in the transition probability matrix, especially when faced with a small sample, interpreting the results with respect to the climate condition less realistic. This study proposes a robust empirical Bayes method, which incorporates a method of smoothing the zero frequencies in the count matrix, contributing to an improved estimation of the transition probability matrix. The robustness of the empirical Bayesian estimation is investigated based on Bayes risk. The transition probability matrices estimated based on the robust empirical Bayes method for the hourly API data collected from seven monitoring stations in Malaysia for the period 2012 to 2014 are used for determining the air pollution characteristics such as the mean residence time, the steady-state probability and the mean recurrence time. Furthermore, the proposed method has been evaluated by Monte Carlo simulations. Results suggest that it is quite effective in producing non-zero transition probability estimates, and superior to the maximum likelihood method in terms of minimizing the mean squared error for individual and entire transition probabilities. Therefore, the robust empirical Bayes method proves to be an improved approach to the estimation of the Markov chain. When applied to API data, it could provide important information on air pollution dynamics that may help guiding the development of proper strategies for managing the impact of air quality.
Supplementary Information: The online version contains supplementary material available at 10.1007/s40201-020-00607-4.
Fulltext A Case of Retroperitoneal Liposarcoma Mimicking an Adrenocortical Carcinoma

Kang W, Singarayar C, Wahab NA, Sukor N, Kamaruddin NA

J ASEAN Fed Endocr Soc, 2019;34(1):95-98.
PMID: 33442143 DOI: 10.15605/jafes.034.01.15

An adrenal mass can be a diagnostic challenge as it is not easy to differentiate the adrenal glands from other adrenal pseudotumours with only radio-imaging. We report a 28-year-old patient who was diagnosed radiologically as an adrenal cortical carcinoma after he presented with abdominal pain and fullness. Biochemically, he demonstrated secondary hyperaldosteronism. Intra-operatively there was a huge mass, inferior to a normal right adrenal, which was histopathologically proven to be a dedifferentiated liposarcoma.
Fulltext Cross-regional analysis of the association between human mobility and COVID-19 infection in Southeast Asia during the transitional period of "living with COVID-19"

Luo W, Zhou Y, Liu Z, Kang W, He S, Zhu R, et al.

Health Place, 2023 Mar 13;81:103000.
PMID: 37011444 DOI: 10.1016/j.healthplace.2023.103000

BACKGROUND: In response to COVID-19, Southeast Asian (SEA) countries had imposed stringent lockdowns and restrictions to mitigate the pandemic ever since 2019. Because of a gradually boosting vaccination rate along with a strong demand for economic recovery, many governments have shifted the intervention strategy from restrictions to "Living with COVID-19" where people gradually resumed their normal activities since the second half of the year 2021. Noticeably, timelines for enacting the loosened strategy varied across Southeast Asian countries, which resulted in different patterns of human mobility across space and time. This thus presents an opportunity to study the relationship between mobility and the number of infection cases across regions, which could provide support for ongoing interventions in terms of effectiveness.
OBJECTIVE: This study aimed to investigate the association between human mobility and COVID-19 infections across space and time during the transition period of shifting strategies from restrictions to normal living in Southeast Asia. Our research results have significant implications for evidence-based policymaking at the present of the COVID-19 pandemic and other public health issues.
METHODS: We aggregated weekly average human mobility data derived from the Facebook origin and destination Movement dataset. and weekly average new cases of COVID-19 at the district level from 01-Jun-2021 to 26-Dec-2021 (a total of 30 weeks). We mapped the spatiotemporal dynamics of human mobility and COVID-19 cases across countries in SEA. We further adopted the Geographically and Temporally Weighted Regression model to identify the spatiotemporal variations of the association between human mobility and COVID-19 infections over 30 weeks. Our model also controls for socioeconomic status, vaccination, and stringency of intervention to better identify the impact of human mobility on COVID-19 spread.
RESULTS: The percentage of districts that presented a statistically significant association between human mobility and COVID-19 infections generally decreased from 96.15% in week 1 to 90.38% in week 30, indicating a gradual disconnection between human mobility and COVID-19 spread. Over the study period, the average coefficients in 7 SEA countries increased, decreased, and finally kept stable. The association between human mobility and COVID-19 spread also presents spatial heterogeneity where higher coefficients were mainly concentrated in districts of Indonesia from week 1 to week 10 (ranging from 0.336 to 0.826), while lower coefficients were mainly located in districts of Vietnam (ranging from 0.044 to 0.130). From week 10 to week 25, higher coefficients were mainly observed in Singapore, Malaysia, Brunei, north Indonesia, and several districts of the Philippines. Despite the association showing a general weakening trend over time, significant positive coefficients were observed in Singapore, Malaysia, western Indonesia, and the Philippines, with the relatively highest coefficients observed in the Philippines in week 30 (ranging from 0.101 to 0.139).
CONCLUSIONS: The loosening interventions in response to COVID-19 in SEA countries during the second half of 2021 led to diverse changes in human mobility over time, which may result in the COVID-19 infection dynamics. This study investigated the association between mobility and infections at the regional level during the special transitional period. Our study has important implications for public policy interventions, especially at the later stage of a public health crisis.
Fulltext Whole-genome sequencing analysis of phenotypic heterogeneity and anticipation in Li-Fraumeni cancer predisposition syndrome

Ariffin H, Hainaut P, Puzio-Kuter A, Choong SS, Chan AS, Tolkunov D, et al.

Proc Natl Acad Sci U S A, 2014 Oct 28;111(43):15497-501.
PMID: 25313051 DOI: 10.1073/pnas.1417322111

The Li-Fraumeni syndrome (LFS) and its variant form (LFL) is a familial predisposition to multiple forms of childhood, adolescent, and adult cancers associated with germ-line mutation in the TP53 tumor suppressor gene. Individual disparities in tumor patterns are compounded by acceleration of cancer onset with successive generations. It has been suggested that this apparent anticipation pattern may result from germ-line genomic instability in TP53 mutation carriers, causing increased DNA copy-number variations (CNVs) with successive generations. To address the genetic basis of phenotypic disparities of LFS/LFL, we performed whole-genome sequencing (WGS) of 13 subjects from two generations of an LFS kindred. Neither de novo CNV nor significant difference in total CNV was detected in relation with successive generations or with age at cancer onset. These observations were consistent with an experimental mouse model system showing that trp53 deficiency in the germ line of father or mother did not increase CNV occurrence in the offspring. On the other hand, individual records on 1,771 TP53 mutation carriers from 294 pedigrees were compiled to assess genetic anticipation patterns (International Agency for Research on Cancer TP53 database). No strictly defined anticipation pattern was observed. Rather, in multigeneration families, cancer onset was delayed in older compared with recent generations. These observations support an alternative model for apparent anticipation in which rare variants from noncarrier parents may attenuate constitutive resistance to tumorigenesis in the offspring of TP53 mutation carriers with late cancer onset.
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Artery Disease: Extended Follow-Up Outcomes of Multicenter Randomized Controlled BEST Trial

Ahn JM, Kang DY, Yun SC, Ho Hur S, Park HJ, Tresukosol D, et al.

Circulation, 2022 Nov 22;146(21):1581-1590.
PMID: 36121700 DOI: 10.1161/CIRCULATIONAHA.122.062188

BACKGROUND: Long-term comparative outcomes after percutaneous coronary intervention (PCI) with everolimus-eluting stents and coronary artery bypass grafting (CABG) are limited in patients with multivessel coronary artery disease.
METHODS: This prospective, multicenter, randomized controlled trial was conducted in 27 international heart centers and was designed to randomly assign 1776 patients with angiographic multivessel coronary artery disease to receive PCI with everolimus-eluting stents or CABG. After inclusion of 880 patients (438 in the PCI group and 442 in the CABG group) between July 2008 and September 2013, the study was terminated early because of slow enrollment. The primary end point was the composite of death from any cause, myocardial infarction, or target vessel revascularization.
RESULTS: During a median follow-up of 11.8 years (interquartile range, 10.6-12.5 years; maximum, 13.7 years), the primary end point occurred in 151 patients (34.5%) in the PCI group and 134 patients (30.3%) in the CABG group (hazard ratio [HR], 1.18 [95% CI, 0.88-1.56]; P=0.26). No significant differences were seen in the occurrence of a safety composite of death, myocardial infarction, or stroke between groups (28.8% and 27.1%; HR, 1.07 [95% CI, 0.75-1.53]; P=0.70), as well as the occurrence of death from any cause (20.5% and 19.9%; HR, 1.04 [95% CI, 0.65-1.67]; P=0.86). However, spontaneous myocardial infarction (7.1% and 3.8%; HR, 1.86 [95% CI, 1.06-3.27]; P=0.031) and any repeat revascularization (22.6% and 12.7%; HR, 1.92 [95% CI, 1.58-2.32]; P<0.001) were more frequent after PCI than after CABG.
CONCLUSIONS: In patients with multivessel coronary artery disease, there were no significant differences between PCI and CABG in the incidence of major adverse cardiac events, the safety composite end point, and all-cause mortality during the extended follow-up.
REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifiers: NCT05125367 and NCT00997828.