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  1. Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.
    BMC Public Health, 2012;12:207.
    PMID: 22429627 DOI: 10.1186/1471-2458-12-207
    BACKGROUND: Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs.
    METHODS: Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios.
    RESULTS: Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01).
    CONCLUSIONS: Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.
  2. Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.
    BMC Public Health, 2011;11:82.
    PMID: 21294919 DOI: 10.1186/1471-2458-11-82
    Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.
  3. Mehrtash H, Duncan K, Parascandola M, David A, Gritz ER, Gupta PC, et al.
    Lancet Oncol, 2017 12;18(12):e767-e775.
    PMID: 29208442 DOI: 10.1016/S1470-2045(17)30460-6
    Betel quid and areca nut are known risk factors for many oral and oesophageal cancers, and their use is highly prevalent in the Asia-Pacific region. Additionally, betel quid and areca nut are associated with health effects on the cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. Unlike tobacco, for which the WHO Framework Convention on Tobacco Control provides evidence-based policies for reducing tobacco use, no global policy exists for the control of betel quid and areca nut use. Multidisciplinary research is needed to address this neglected global public health emergency and to mobilise efforts to control betel quid and areca nut use. In addition, future research is needed to advance our understanding of the basic biology, mechanisms, and epidemiology of betel quid and areca nut use, to advance possible prevention and cessation programmes for betel quid and areca nut users, and to design evidence-based screening and early diagnosis programmes to address the growing burden of cancers that are associated with use.
  4. Pramanik A, Basak AK, Littlefair G, Debnath S, Prakash C, Singh MA, et al.
    Heliyon, 2020 Dec;6(12):e05554.
    PMID: 33344787 DOI: 10.1016/j.heliyon.2020.e05554
    Titanium alloys are difficult to machine using conventional methods, therefore, nonconventional processes are often chosen in many applications. Electrical discharge machining (EDM) is one of those nonconventional processes that is used frequently for shaping titanium alloys with their respective pros and cons. However, a good understanding of this process is very difficult to achieve as research results are not properly connected and presented. Therefore, this study investigates different types of EDM processes such as, wire EDM, die-sink EDM, EDM drill and hybrid EDM used to machine titanium alloys. Machining mechanism, tool electrode, dielectric, materials removal rate (MRR), and surface integrity of all these processes are critically analysed and correlated based on the evidence accessible in literature. Machining process suffer from lower material removal rate and high tool wear while applied on titanium alloys. Formation of recast layer, heat affected zone and tool wear is common in all types of EDM processes. Additional challenge in wire EDM of titanium alloys is wire breakage under severe machining conditions. The formation of TiC and TiO2 are noticed in recast layer depending on the type of dielectrics. Removal of debris from small holes during EDM drilling is a challenge. All these restricts the applications EDMed titanium alloys in high-tech applications such as, aerospace and biomedical areas. Most of these challenges come up due to extraordinary properties such as, low thermal conductivity, high melting point and high hardness, of titanium alloys. Though hybrid EDM has been introduced and there is some work on simulation of EDM process, further developments in EDM of this alloy is required for widening the application of this methods.
  5. Keech AC, Oyama K, Sever PS, Tang M, Murphy SA, Hirayama A, et al.
    Circ J, 2021 Oct 25;85(11):2063-2070.
    PMID: 33980763 DOI: 10.1253/circj.CJ-20-1051
    BACKGROUND: There are concerns that Asian patients respond differently to some medications. This study evaluated the efficacy and safety of evolocumab among Asian vs. other subjects in the FOURIER trial, which randomized stable atherosclerosis patients to receive either evolocumab or placebo.Methods and Results:Effects of adding evolocumab vs. placebo to background statin therapy on low-density lipoprotein cholesterol (LDL-C) reductions, cardiovascular outcomes, and adverse events were compared among 27,564 participants with atherosclerotic disease, according to self-reported Asian (n=2,723) vs. other (n=24,841) races followed for a median of 2.2 years in the FOURIER trial. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. At randomization, Asians had slightly lower LDL-C (median 89 [IQR 78-104] mg/dL vs. 92 [80-109] mg/dL; P<0.001) and were much less likely to be on a high-intensity statin (33.3% vs. 73.3%; P<0.001). Evolocumab lowered LDL-C more in Asians than in others (66% vs. 58%; P<0.001). The effect of evolocumab on the primary endpoint was similar in Asians (HR, 0.79; 95% CI, 0.61-1.03) and others (HR, 0.86; 95% CI, 0.79-0.93; P interaction=0.55). There was no excess of serious adverse events with evolocumab among Asians over others.

    CONCLUSIONS: Use of evolocumab robustly lowers LDL-C and is equally efficacious in lowering the risk of cardiovascular events and safe in Asians as it is in others.

  6. Prakash C, Pramanik A, Basak AK, Dong Y, Debnath S, Shankar S, et al.
    Materials (Basel), 2021 Mar 30;14(7).
    PMID: 33808311 DOI: 10.3390/ma14071699
    In the present research work, an effort has been made to explore the potential of using the adhesive tapes while drilling CFRPs. The input parameters, such as drill bit diameter, point angle, Scotch tape layers, spindle speed, and feed rate have been studied in response to thrust force, torque, circularity, diameter error, surface roughness, and delamination occurring during drilling. It has been found that the increase in point angle increased the delamination, while increase in Scotch tape layers reduced delamination. The surface roughness decreased with the increase in drill diameter and point angle, while it increased with the speed, feed rate, and tape layer. The best low roughness was obtained at 6 mm diameter, 130° point angle, 0.11 mm/rev feed rate, and 2250 rpm speed at three layers of Scotch tape. The circularity error initially increased with drill bit diameter and point angle, but then decreased sharply with further increase in the drill bit diameter. Further, the circularity error has non-linear behavior with the speed, feed rate, and tape layer. Low circularity error has been obtained at 4 mm diameter, 118° point angle, 0.1 mm/rev feed rate, and 2500 RPM speed at three layers of Scotch tape. The low diameter error has been obtained at 6 mm diameter, 130° point angle, 0.12 mm/rev feed rate, and 2500 rpm speed at three layer Scotch tape. From the optical micro-graphs of drilled holes, it has been found that the point angle is one of the most effective process parameters that significantly affects the delamination mechanism, followed by Scotch tape layers as compared to other parameters such as drill bit diameter, spindle speed, and feed rate.
  7. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, et al.
    JAMA Oncol, 2019 12 01;5(12):1749-1768.
    PMID: 31560378 DOI: 10.1001/jamaoncol.2019.2996
    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

    Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

    Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

    Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs).

    Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

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