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Development of formaldehyde-free bio-board produced from mushroom mycelium and substrate waste

Khoo SC, Peng WX, Yang Y, Ge SB, Soon CF, Ma NL, et al.

J Hazard Mater, 2020 12 05;400:123296.
PMID: 32947701 DOI: 10.1016/j.jhazmat.2020.123296

Synthetic adhesives in the plywood industry are usually volatile compounds such as formaldehyde-based chemical which are costly and hazardous to health and the environment. This phenomenon promotes an interest in developing bio-boards without synthetic adhesives. This study proposed a novel application of natural mycelium produced during mushroom cultivation as natural bio-adhesive material that convert spent mushroom substrate (SMS) into high-performance bio-board material. Different types of spent mushroom substrates were compressed with specific designed mould with optimal temperature at 160 °C and 10 mPa for 20 min. The bio-board made from Ganoderma lucidum SMS had the highest internal bonding strength up to 2.51 mPa. This is far above the 0.4-0.8 range of China and US national standards. In addition, the material had high water and fire resistance, high bonding and densified structures despite free of any adhesive chemicals. These properties and the low cost one step procedure show the potential as a zero-waste economy chain for sustainable agricultural practice for waste and remediation.
Intraoperative Computed Tomography Scan for Orbital Fracture Reconstruction

Nazimi AJ, Khoo SC, Nabil S, Nordin R, Lan TH, Rajandram RK, et al.

J Craniofac Surg, 2019 Oct;30(7):2159-2162.
PMID: 31232997 DOI: 10.1097/SCS.0000000000005667

Orbital fractures pose specific challenge in its surgical management. One of the greatest challenges is to obtain satisfactory reconstruction by correct positioning of orbital implant. Intraoperative computed tomography (CT) scan may facilitate this procedure. The aim of this study was to describe the early use of intraoperative CT in orbital fractures repair in our center. The authors assessed the revision types and rates that have occurred with this technique. With the use of pre-surgical planning, optical intraoperative navigation, and intraoperative CT, the impact of intraoperative CT on the management of 5 cases involving a total number of 14 orbital wall fractures were described. There were 6 pure orbital blowout wall fractures reconstructed, involving both medial and inferior wall of the orbit fracturing the transition zone and 8 impure orbital wall fractures in orbitozygomaticomaxillary complex fracture. 4 patients underwent primary and 1 had delayed orbital reconstruction. Intraoperative CT resulted in intraoperative orbital implant revision, following final navigation planning position, in 40% (2/5) of patients or 14% (2/14) of the fractures. In revised cases, both implant repositioning was conducted at posterior ledge of orbit. Intraoperative CT confirmed true to original reconstruction of medial wall, inferior wall and transition zone of the orbit. Two selected cases were illustrated. In conclusion, intraoperative CT allows real-time assessment of fracture reduction and immediate orbital implant revision, especially at posterior ledge. As a result, no postoperative imaging was indicated in any of the patients. Long-term follow-ups for orbital fracture patients managed with intraoperative CT is suggested.
Fulltext Predictors of osteoradionecrosis following irradiated tooth extraction

Khoo SC, Nabil S, Fauzi AA, Yunus SSM, Ngeow WC, Ramli R

Radiat Oncol, 2021 Jul 14;16(1):130.
PMID: 34261515 DOI: 10.1186/s13014-021-01851-0

BACKGROUND: Tooth extraction post radiotherapy is one of the most important risk factors of osteoradionecrosis of the jawbones. The objective of this study was to determine the predictors of osteoradionecrosis (ORN) which were associated with a dental extraction post radiotherapy.
METHODS: A retrospective analysis of medical records and dental panoramic tomogram (DPT) of patients with a history of head and neck radiotherapy who underwent dental extraction between August 2005 to October 2019 was conducted.
RESULTS: Seventy-three patients fulfilled the inclusion criteria. 16 (21.9%) had ORN post dental extraction and 389 teeth were extracted. 33 sockets (8.5%) developed ORN. Univariate analyses showed significant associations with ORN for the following factors: tooth type, tooth pathology, surgical procedure, primary closure, target volume, total dose, timing of extraction post radiotherapy, bony changes at extraction site and visibility of lower and upper cortical line of mandibular canal. Using multivariate analysis, the odds of developing an ORN from a surgical procedure was 6.50 (CI 1.37-30.91, p = 0.02). Dental extraction of more than 5 years after radiotherapy and invisible upper cortical line of mandibular canal on the DPT have the odds of 0.06 (CI 0.01-0.25, p
Fulltext Antioxidant, Metal Chelating, Anti-glucosidase Activities and Phytochemical Analysis of Selected Tropical Medicinal Plants

Wong FC, Yong AL, Ting EP, Khoo SC, Ong HC, Chai TT

Iran J Pharm Res, 2014;13(4):1409-15.
PMID: 25587331

The purpose of this investigation was to determine the antioxidant potentials and anti-glucosidase activities of six tropical medicinal plants. The levels of phenolic constituents in these medicinal plants were also quantified and compared. Antioxidation potentials were determined colorimetrically for scavenging activities against DPPH and NO radicals. Metal chelating assay was based on the measurement of iron-ferrozine absorbance at 562 nm. Anti-diabetic potentials were measured by using α-glucosidase as target enzyme. Medicinal plants' total phenolic, total flavonoid and hydroxycinnamic acid contents were determined using spectrophotometric methods, by comparison to standard plots prepared using gallic acid, quercetin and caffeic acid standards, respectively. Radical scavenging and metal chelating activities were detected in all medicinal plants, in concentration-dependent manners. Among the six plants tested, C. nutans, C. formosana and H. diffusa were found to possess α-glucosidase inhibitory activities. Spectrophotometric analysis indicated that the total phenolic, total flavonoid and hydroxycinnamic acid contents ranged from 12.13-21.39 mg GAE per g of dry sample, 1.83-9.86 mg QE per g of dry sample, and 0.91-2.74 mg CAE per g of dry sample, respectively. Our results suggested that C. nutans and C. formosana could potentially be used for the isolation of potent antioxidants and anti-diabetic compounds. To the best of our knowledge, this study represents the first time that C. nutans (Acanthaceae family) was reported in literature with glucosidase inhibition activity.
Exploring environmental exposomes and the gut-brain nexus: Unveiling the impact of pesticide exposure

Khoo SC, Zhang N, Luang-In V, Goh MS, Sonne C, Ma NL

Environ Res, 2024 Feb 11;250:118441.
PMID: 38350544 DOI: 10.1016/j.envres.2024.118441

This review delves into the escalating concern of environmental pollutants and their profound impact on human health in the context of the modern surge in global diseases. The utilisation of chemicals in food production, which results in residues in food, has emerged as a major concern nowadays. By exploring the intricate relationship between environmental pollutants and gut microbiota, the study reveals a dynamic bidirectional interplay, as modifying microbiota profile influences metabolic pathways and subsequent brain functions. This review will first provide an overview of potential exposomes and their effect to gut health. This paper is then emphasis the connection of gut brain function by analysing microbiome markers with neurotoxicity responses. We then take pesticide as example of exposome to elucidate their influence to biomarkers biosynthesis pathways and subsequent brain functions. The interconnection between neuroendocrine and neuromodulators elements and the gut-brain axis emerges as a pivotal factor in regulating mental health and brain development. Thus, manipulation of gut microbiota function at the onset of stress may offer a potential avenue for the prevention and treatment for mental disorder and other neurodegenerative illness.
Fulltext Application of antimicrobial, potential hazard and mitigation plans

Khoo SC, Goh MS, Alias A, Luang-In V, Chin KW, Ling Michelle TH, et al.

Environ Res, 2022 Dec;215(Pt 1):114218.
PMID: 36049514 DOI: 10.1016/j.envres.2022.114218

The tremendous rise in the consumption of antimicrobial products had aroused global concerns, especially in the midst of pandemic COVID-19. Antimicrobial resistance has been accelerated by widespread usage of antimicrobial products in response to the COVID-19 pandemic. Furthermore, the widespread use of antimicrobial products releases biohazardous substances into the environment, endangering the ecology and ecosystem. Therefore, several strategies or measurements are needed to tackle this problem. In this review, types of antimicrobial available, emerging nanotechnology in antimicrobial production and their advanced application have been discussed. The problem of antimicrobial resistance (AMR) due to antibiotic-resistant bacteria (ARB)and antimicrobial resistance genes (AMG) had become the biggest threat to public health. To deal with this problem, an in-depth discussion of the challenges faced in antimicrobial mitigations and potential alternatives was reviewed.
Fulltext Modified J-CAPRA scoring system in predicting treatment outcomes of metastatic prostate cancer patients undergoing androgen deprivation therapy

Lim J, Hinotsu S, Onozawa M, Malek R, Sundram M, Teh GC, et al.

Cancer Med, 2020 12;9(24):9346-9352.
PMID: 33098372 DOI: 10.1002/cam4.3548

The J-CAPRA score is an assessment tool which stratifies risk and predicts outcome of primary androgen deprivation therapy (ADT) using prostate-specific antigen, Gleason score, and clinical TNM staging. Here, we aimed to assess the generalisability of this tool in multi-ethnic Asians. Performance of J-CAPRA was evaluated in 782 Malaysian and 16,946 Japanese patients undergoing ADT from the Malaysian Study Group of Prostate Cancer (M-CaP) and Japan Study Group of Prostate Cancer (J-CaP) databases, respectively. Using the original J-CAPRA, 69.6% metastatic (M1) cases without T and/or N staging were stratified as intermediate-risk disease in the M-CaP database. To address this, we first omitted clinical T and N stage variables, and calculated the score on a 0-8 scale in the modified J-CAPRA scoring system for M1 patients. Notably, treatment decisions of M1 cases were not directly affected by both T and N staging. The J-CAPRA score threshold was adjusted for intermediate (modified J-CAPRA score 3-5) and high-risk (modified J-CAPRA score ≥6) groups in M1 patients. Using J-CaP database, validation analysis showed that overall survival, prostate cancer-specific survival, and progression-free survival of modified intermediate and high-risk groups were comparable to those of original J-CAPRA (p > 0.05) with Cohen's coefficient of 0.65. Around 88% M1 cases from M-CaP database were reclassified into high-risk category. Modified J-CAPRA scoring system is instrumental in risk assessment and treatment outcome prediction for M1 patients without T and/or N staging.
Fulltext Valorisation of biomass and diaper waste into a sustainable production of the medical mushroom Lingzhi Ganoderma lucidum

Khoo SC, Ma NL, Peng WX, Ng KK, Goh MS, Chen HL, et al.

Chemosphere, 2022 Jan;286(Pt 1):131477.
PMID: 34303046 DOI: 10.1016/j.chemosphere.2021.131477

Global solid waste is expected to increase by at least 70% annually until year 2050. The mixture of solid waste including food waste from food industry and domestic diaper waste in landfills is causing environmental and human health issues. Nevertheless, food and diaper waste containing high lignocellulose can easily degrade using lignocellulolytic enzymes thereby converted into energy for the development and growth of mushroom. Therefore, this study explores the potential of recycling biomass waste from coffee ground, banana, eggshell, tea waste, sugarcane bagasse and sawdust and diaper waste as raw material for Lingzhi mushroom (Ganoderma lucidum) cultivation. Using 2% of diaper core with sawdust biowaste leading to the fastest 100% mushroom mycelium spreading completed in one month. The highest production yield is 71.45 g mushroom; this represents about 36% production biological efficiency compared to only 21% as in commercial substrate. The high mushroom substrate reduction of 73% reflect the valorisation of landfill waste. The metabolomics profiling showed that the Lingzhi mushroom produced is of high quality with a high content of triterpene being the bioactive compounds that are medically important for treating assorted disease and used as health supplement. In conclusion, our study proposed a potential resource management towards zero-waste and circular bioeconomy for high profitable mushroom cultivation.
A review of historical and recent locust outbreaks: Links to global warming, food security and mitigation strategies

Peng W, Ma NL, Zhang D, Zhou Q, Yue X, Khoo SC, et al.

Environ Res, 2020 12;191:110046.
PMID: 32841638 DOI: 10.1016/j.envres.2020.110046

Locusts differ from ordinary grasshoppers in their ability to swarm over long distances and are among the oldest migratory pests. The ecology and biology of locusts make them among the most devastating pests worldwide and hence the calls for actions to prevent the next outbreaks. The most destructive of all locust species is the desert locust (Schistocerca gregaria). Here, we review the current locust epidemic 2020 outbreak and its causes and prevention including the green technologies that may provide a reference for future directions of locust control and food security. Massive locust outbreaks threaten the terrestrial environments and crop production in around 100 countries of which Ethiopia, Somalia and Kenya are the most affected. Six large locust outbreaks are reported for the period from 1912 to 1989 all being closely related to long-term droughts and warm winters coupled with occurrence of high precipitation in spring and summer. The outbreaks in East Africa, India and Pakistan are the most pronounced with locusts migrating more than 150 km/day during which the locusts consume food equivalent to their own body weight on a daily basis. The plague heavily affects the agricultural sectors, which is the foundation of national economies and social stability. Global warming is likely the main cause of locust plague outbreak in recent decades driving egg spawning of up to 2-400,000 eggs per square meter. Biological control techniques such as microorganisms, insects and birds help to reduce the outbreaks while reducing ecosystem and agricultural impacts. In addition, green technologies such as light and sound stimulation seem to work, however, these are challenging and need further technological development incorporating remote sensing and modelling before they are applicable on large-scales. According to the Food and Agriculture Organization (FAO) of the United Nations, the 2020 locust outbreak is the worst in 70 years probably triggered by climate change, hurricanes and heavy rain and has affected a total of 70,000 ha in Somalia and Ethiopia. There is a need for shifting towards soybean, rape, and watermelon which seems to help to prevent locust outbreaks and obtain food security. Furthermore, locusts have a very high protein content and is an excellent protein source for meat production and as an alternative human protein source, which should be used to mitigate food security. In addition, forestation of arable land improves local climate conditions towards less precipitation and lower temperatures while simultaneously attracting a larger number of birds thereby increasing the locust predation rates.
Fulltext Prostate cancer in multi-ethnic Asian men: Real-world experience in the Malaysia Prostate Cancer (M-CaP) Study

Lim J, Malek R, Jr S, Toh CC, Sundram M, Woo SYY, et al.

Cancer Med, 2021 11;10(22):8020-8028.
PMID: 34626088 DOI: 10.1002/cam4.4319

Prostate cancer is the third most common cancer in Malaysia with the lifetime risk of 1 in 117 men. Here, we initiated a longitudinal Malaysia Prostate Cancer (M-CaP) Study to investigate the clinical and tumour characteristics, treatment patterns as well as disease outcomes of multi-ethnic Asian men at real-world setting. The M-CaP database consisted of 1839 new patients with prostate cancer diagnosed between 2016 and 2018 from nine public urology referral centres across Malaysia. Basic demographic and clinical parameters, tumour characteristics, primary treatment, follow-up and vital status data were retrieved prospectively from the hospital-based patients' case notes or electronic medical records. Primary endpoints were overall survival (OS) and biochemical progression-free survival (bPFS). The median age at diagnosis of M-CaP patients was 70 years (interquartile range, IQR 65-75). Majority of patients were Chinese (831, 45.2%), followed by Malays (704, 38.3%), Indians (124, 6.7%) and other races (181, 9.8%). The median follow-up for all patients was 23.5 months (IQR 15.9-33.6). Although 58.1% presented with late-stage cancer, we observed ethnic and geographic disparities in late-stage prostate cancer diagnosis. Curative radiotherapy and primary androgen deprivation therapy were the most common treatment for stage III and stage IV diseases, respectively. The median OS and bPFS of stage IV patients were 40.1 months and 19.2 months (95% CI 17.6-20.8), respectively. Late stage at presentation remains a challenge in multi-ethnic Asian men. Early detection is imperative to improve treatment outcome and survival of patients with prostate cancer.
Association between dietary 3-monochloropropane-1,2-diol esters (3-MCPDE) and renal cancer in Peninsular Malaysia: exposure assessment and matched case-control study

Muhamad Rosli SH, Lau MS, Khalid T, Maarof SK, Jeyabalan S, Sirdar Ali S, et al.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 2023 Apr;40(4):475-492.
PMID: 36947708 DOI: 10.1080/19440049.2023.2183068

3-Monochloropropane-1,2-diol esters (3-MCPDE) are food contaminants commonly found in refined vegetable oils and fats, which have possible carcinogenic implications in humans. To investigate this clinically, we conducted an occurrence level analysis on eight categories of retail and cooked food commonly consumed in Malaysia. This was used to estimate the daily exposure level, through a questionnaire-based case-control study involving 77 subjects with renal cancer, with 80 matching controls. Adjusted Odds Ratio (AOR) was calculated using the multiple logistic regression model adjusted for confounding factors. A pooled estimate of total 3-MCPDE intake per day was compared between both groups, to assess exposure and disease outcome. Among the food categories analysed, vegetable fats and oils recorded the highest occurrence levels (mean: 1.91 ± 1.90 mg/kg), significantly more than all other food categories (p

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