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Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is both a human commensal and a pathogen that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of infections in neonatal intensive care units as well as community infections have been reported mostly in developed countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility pattern among term neonates in our facility., Methodology: It was a prospective cross-sectional hospital-based study carried out from October 2018 to July 2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique respectively., Results: Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the most effective antibiotics against the identified pathogens., Conclusion: The presence of MRSA infections in neonates poses a critical public health threat. This trend underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory., (Copyright © 2024 Nigerian Medical Association.)

The increasing demand for sustainable manufacturing has revived the interest in solid-state recycling (SSR) as a promising alternative method for aluminum waste. In this context, chips generated during machining processes constitute a substantial portion of aluminum waste, offering significant potential for recycling and mitigating waste. However, the machining chip morphology significantly impacts the properties of chip-based recycled parts. This review paper examines the current state-of-the-art solid-state recycling methods, focusing on hot forging, extrusion, equal channel angular pressing, friction stir extrusion and field-assisted sintering. It investigates the impact of aluminum chip morphology on the properties of the directly recycled material, emphasizing the chip machining consequence on the final quality of the product. Several studies reported that the strain and operating temperature are the most influential factors in SSR processes, followed by chip size with an average length of less than 4 mm. Yet, the heating time up to 3 h also had a major impact on chip weld strength. The findings highlighted the significance of aluminum chip morphology in improving the quality of recycled material. The properties of direct recycled samples primarily depend on chip weld strength and microstructure. Overall, this study presented a comprehensive overview of the current state of solid-state recycling and emphasized the significance of chip morphology in advancing the recycling process. Consequently, it equips researchers with a valuable resource for developing effective strategies for sustainable recycling of aluminum chips with high quality., Competing Interests: The author W.Z. is an Associate Editor for Heliyon and was not involved in the editorial review or the decision to publish this article., (© 2024 The Authors.)

The optimal conditions of applied factors to reuse Aluminium AA6061 scraps are (450, 500, and 550) ⁰C preheating temperature, (1-15) % Boron Carbide (B 4 C), and Zirconium (ZrO 2 ) hybrid reinforced particles at 120 min forging time via Hot Forging (HF) process. The response surface methodology (RSM) and machine learning (ML) were established for the optimisations and comparisons towards materials strength structure. The Ultimate Tensile Strength (UTS) strength and Microhardness (MH) were significantly increased by increasing the processed temperature and reinforced particles because of the material dispersion strengthening. The high melting point of particles caused impedance movements of aluminium ceramics dislocations which need higher plastic deformation force and hence increased the material's mechanical and physical properties. But, beyond Al/10 % B 4 C + 10 % ZrO 2 the strength and hardness were decreased due to more particle agglomeration distribution. The optimisation tools of both RSM and ML show high agreement between the reported results of applied parameters towards the materials' strength characterisation. The microstructure analysis of Field Emission Scanning Electron Microscopy (FE-SEM) and Atomic Force Microscope (AFM) provides insights mapping behavioural characterisation supports related to strength and hardness properties. The distribution of different volumes of ceramic particle proportion was highlighted. The environmental impacts were also analysed by employing a life cycle assessment (LCA) to identify energy savings because of its fewer processing steps and produce excellent hybrid materials properties., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Direct recycling of aluminum waste is crucial in sustainable manufacturing to mitigate environmental impact and conserve resources. This work was carried out to study the application of hot press forging (HPF) in recycling AA6061 aluminum chip waste, aiming to optimize operating factors using Response Surface Methodology (RSM), Artificial Neural Network (ANN) and Genetic algorithm (GA) strategy to maximize the strength of recycled parts. The experimental runs were designed using Full factorial and RSM via Minitab 21 software. RSM-ANN models were employed to examine the effect of factors and their interactions on response and to predict output, while GA-RSM and GA-ANN were used for optimization. The chips of different morphology were cold compressed into billet form and then hot forged. The effect of varying forging temperature (Tp, 450-550°C), holding time (HT, 60-120 minutes), and chip surface area to volume ratio (AS:V, 15.4-52.6 mm2/mm3) on ultimate tensile strength (UTS) was examined. Maximum UTS (237.4 MPa) was achieved at 550°C, 120 minutes and 15.4 mm2/mm3 of chip's AS: V. The Tp had the largest contributing effect ratio on the UTS, followed by HT and AS:V according to ANOVA analysis. The proposed optimization process suggested 550°C, 60 minutes, and 15.4 mm2 as the optimal condition yielding the maximum UTS. The developed models' evaluation results showed that ANN (with MSE = 1.48%) outperformed RSM model. Overall, the study promotes sustainable production by demonstrating the potential of integrating RSM and ML to optimize complex manufacturing processes and improve product quality., Competing Interests: Acknowledgment (The authors extend their appreciation to King Saud University for funding this work through Researchers Supporting Project number (RSPD2023R711), King Saud University, Riyadh, Saudi Arabia.) This research was funded by King Saud University through Researchers Supporting Project number (RSPD2023R711). This research was supported by Universiti Tun Hussein Onn Malaysia (UTHM) through Tier 1 (Q390). (Communication of this research is made possible through monetary assistance by Universiti Tun Hussein Onn Malaysia and the UTHM Publisher’s Office via Publication Fund E15216. The authors would also like to express the most profound appreciation for supplementary provisions provided by Sustainable Manufacturing and Recycling Technology, Advanced Manufacturing and Materials Center (SMART-AMMC), Universiti Tun Hussein Onn Malaysia)., (Copyright: © 2024 Altharan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Nowadays there are numerous discovered natural RNA variations participating in different cellular processes and artificial RNA, e. g., aptamers, riboswitches. One of the required tasks in the investigation of their functions and mechanism of influence on cells and interaction with targets is the prediction of RNA secondary structures. The classic thermodynamic-based prediction algorithms do not consider the specificity of biological folding and deep learning methods that were designed to resolve this issue suffer from homology-based methods problems. Herein, we present a method for RNA secondary structure prediction based on deep learning - AliNA (ALIgned Nucleic Acids). Our method successfully predicts secondary structures for non-homologous to train-data RNA families thanks to usage of the data augmentation techniques. Augmentation extends existing datasets with easily-accessible simulated data. The proposed method shows a high quality of prediction across different benchmarks including pseudoknots. The method is available on GitHub for free (https://github.com/Arty40m/AliNA)., (© 2023 Wiley-VCH GmbH.)

Background: Genital Chlamydia trachomatis (Ct) is the commonest bacterial sexually transmitted infection globally. Acquisition of Ct infection is affected by biological and behavioural factors., Aim: Determine the prevalence of Ct infection and identify risk factors associated with Ct infection in sexually active fertile women in Northern Nigeria., Materials and Methods: One hundred and fifty sexually active women presenting to the Obstetrics and Gynaecology department of Ahmadu Bello University Teaching Hospital, Zaria were studied. Socio-demographic characteristics and history of risk factors for acquisition of genital Ct were obtained from the participants using a questionnaire. Their sera were tested for the presence of Ct immunoglobulin G using Enzyme-Linked Immunosorbent Assay., Results: The mean ages ± standard deviation of seropositive and seronegative women were 29.1 ± 7.3 years and 28.9 (SD 6.7) years respectively ( P = 0.438). The prevalence of Ct infection was 6.7% (10/150). Occupation was associated with Ct seropositivity ( P = 0.02). Number of sexual partners, age at coitarche; duration of sexual exposure and previous history suggestive of sexually transmitted infection were not associated with Ct seropositivity ( P > 0.05)., Conclusion: A low prevalence of Ct was found among fertile women. Lack of regular source of personal income was associated with Ct infection but the sexual behavioural factors studied were not., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of West African College of Surgeons.)

RNA editing by adenosine deaminases of the ADAR family can lead to protein recoding, since inosine formed from adenosine in mRNA is complementary to cytosine; the resulting codon editing might introduce amino acid substitutions into translated proteins. Proteome recoding can have functional consequences which have been described in many animals including humans. Using protein recoding database derived from publicly available transcriptome data, we identified for the first time the recoding sites in the zebrafish shotgun proteomes. Out of more than a hundred predicted recoding events, ten substitutions were found in six used datasets. Seven of them were in the AMPA glutamate receptor subunits, whose recoding has been well described, and are conserved among vertebrates. Three sites were specific for zebrafish proteins and were found in the transmembrane receptors astrotactin 1 and neuregulin 3b (proteins involved in the neuronal adhesion and signaling) and in the rims2b gene product (presynaptic membrane protein participating in the neurotransmitter release), respectively. Further studies are needed to elucidate the role of recoding of the said three proteins in the zebrafish.

Enterobacter agglomerans formerly termed Erwina herbicola but now called Pantonea agglomerans is a ubiquitous gram-negative bacterium that rarely causes mild and opportunistic infection in humans. Sources of infection are myriad causing both local and systemic disease across all systems of the body. Infection is often fulminant and fatal in neonates. We aim to report another facet of the infection as seen in our centre. Of the 248 neonates recruited into the study, 94 had bacteria isolated from their blood, eight (8.5%) of whom had E. agglomerans sepsis. Infection was acquired from the community though its source could not be determined. The clinical features were non-specific running a mild course. Toxic granulation, elevated immature polymorph count and procalcitonin level was found in 50% and 75% of the neonates. Isolate was sensitive to most tested antibiotics, showing 100% sensitivity to gentamicin and ciprofloxacin and the survival rate was excellent (87.5%)., (© The Author(s) [2022]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The self-healing of bio-concrete cracks and pores have been utilised worldwide to improve the properties of bio-concrete using different types of bacteria. Meanwhile, no published research was conducted to heal bio-foamed concrete bricks (B-FCB) pores using Bacillus tequilensis. Previous studies focused on the concentration of bacteria and neglect other factors that could affect the healing process. This research aimed to optimise the healing ratio of B-FCB pores using four factors: B. tequilensis concentration, concrete density, temperature and CO 2 concentration. Initial water absorption (IWA) and water absorption (WA) were used as responses in statistical methods, namely, factorial and response surface methodology (RSM). B. tequilensis species was isolated from cement kiln dust, produced in a powder form, then subjected to simulate test using a special medium consisting of foamed concrete materials to check the survival ability in B-FCB. SEM, EDX, and XRD were used to investigate the healing process of B-FCB pores. The results revealed that the decrement ratios of IWA and WA of B-FCB were 52.8% and 29.1% compared to FCB, respectively. SEM results reflect the healing that occurred in B-FCB pores, mostly healed via precipitation of CaCO 3 as demonstrated on the XRD results., (© 2022. The Author(s).)

Direct solid-states, such as hot extrusion and equal channel angular pressing (ECAP), are alternative and efficient solid-state processes for use in recycling aluminium scrap. These processes utilise less energy and are eco-friendly. Ceramic particles such as ZrO 2 are suggested as alternatives in the production of metal composites. This study investigated and optimised the effects of various parameters of reinforced ZrO 2 nanoparticles on the mechanical and physical properties via response surface methodology (RSM). These parameters were the volume fraction (VF), preheating temperature (T), and preheating time (t). The effects of these parameters were examined before and after the heat treatment condition and ECAP. Each parameter was evaluated at varying magnitudes, i.e., 450, 500, and 550 °C for T, 1, 2, and 3 h for t, and 1, 3, and 5% for VF. The effect that process variables had on responses was elucidated using the factorial design with centre point analysis. T and VF were crucial for attaining the optimum ultimate tensile strength (UTS) and microhardness. Reducing VF increased the mechanical properties to 1 vol% of oxide. The maximum hardness of 95 HV was attained at 550 °C, 1.6 h, and 1 vol% ZrO 2 with a density of 2.85 g/cm 3 and tensile strength of 487 MPa. UTS, density, and microhardness were enhanced by 14%, 1%, and 9.5%, respectively. Additionally, the hot extrusion parameters and ECAP followed by heat treatment strengthened the microhardness by 64% and density by 3%. Compression pressure and extrusion stress produced in these stages were sufficient to eliminate voids that increased the mechanical properties.

To date, various studies have analysed the effects of reinforced ceramic on the properties of AA6061 recycled aluminum alloy chips, such as the tensile strength and fractography. However, a comprehensive analysis of the properties of hybrid composite with the addition of nano-silica oxide and nano-copper oxide reinforcements is still very limited. Therefore, this study aimed to optimise the factors comprising the preheating temperature (PHT), preheating time (PHti), and volume fraction (VF) of reinforcements then determine their impacts on the physical and mechanical properties of the recycled solid-state extruded composite aluminum chips. A total of 45 specimens were fabricated through the hot extrusion technique. The response surface methodology (RSM) was employed to study the optimisation at a PHT range of 450-550 °C with PHti of 1-3 h and VF of 1-3 vol% for both reinforcements (SiO 2 and CuO). Moreover, a random forest (RF) model was developed to optimize the model based on a metaheuristic method to improve the model performance. Based on the experimental results the RF model achieve better results than response surface methodology (RSM). The functional quadratic regression is curvature and the tested variable shows stable close data of the mean 0 and α2. Based on the Pareto analysis, the PHT and VF were key variables that significantly affected the UTS, microhardness, and density of the product. The maximum properties were achieved at an optimum PHT, PHti, and VF of 541 °C, 2.25 h, 1 vol% SiO 2 and 2.13 vol% CuO, respectively. Furthermore, the morphological results of the tensile fractured surface revealed the homogenous distribution of nano-reinforced CuO and SiO 2 particles in the specimens' structure.

This research aimed to optimize the compressive strength of bio-foamed concrete brick (B-FCB) via a combination of the natural sequestration of CO 2 and the bio-reaction of B. tequilensis enzymes. The experiments were guided by two optimization methods, namely, 2 k factorial and response surface methodology (RSM). The 2 k factorial analysis was carried out to screen the important factors; then, RSM analysis was performed to optimize the compressive strength of B-FCB. Four factors, namely, density (D), B. tequilensis concentration (B), temperature (T), and CO 2 concentration, were selectively varied during the study. The optimum compressive strength of B-FCB was 8.22 MPa, as deduced from the following conditions: 10% CO 2 , 3 × 10 7 cell/mL of B, 27 °C of T and 1800 kg/m 3 of D after 28 days. The use of B. tequilensis in B-FCB improved the compressive strength by 35.5% compared to the foamed concrete brick (FCB) after 28 days. A microstructure analysis by scanning electronic microscopy (SEM), energy dispersive X-ray (EDX) and X-ray diffraction analysis (XRD) reflected the changes in chemical element levels and calcium carbonate (CaCO 3 ) precipitation in the B-FCB pores. This was due to the B. tequilensis surface reactions of carbonic anhydrase (CA) and urease enzyme with calcium in cement and sequestered CO 2 during the curing time.

Background: As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physicians in tertiary hospitals in Nigeria, and to determine predictors of KAP of APR and AMR., Methods: In this cross-sectional study, we enrolled physicians practicing in tertiary hospitals from all six geopolitical zones of Nigeria. Implementation of an antimicrobial stewardship programmes (ASP) by each selected hospital were assessed using a 12 item ASP checklist. We used a structured self-administered questionnaire to assess the KAP of APR and AMR. Frequency of prescriptions of 18 different antibiotics in the prior 6 months was assessed using a Likert's scale. KAP and prescription (Pr) scores were classified as good (score ≥ 80%) or average/poor (score < 80%). Independent predictors of good knowledge, attitude, and practice (KAPPr) were ascertained using an unconditional logistic regression model., Results: A total of 1324 physicians out of 1778 (74% response rate) practicing in 12 tertiary hospitals in 11 states across all six geopolitical zones participated in the study. None of the participating hospitals had a formal ASP programme and majority did not implement antimicrobial stewardship strategies. The median KAPPr scores were 71.1%, 77%, 75% and 53.3%, for the knowledge, attitude, practice, and prescription components, respectively. Only 22.3%, 40.3%, 31.6% and 31.7% of study respondents had good KAPPr, respectively. All respondents had prescribed one or more antibiotics in the prior 6 months, mostly Amoxicillin-clavulanate (98%), fluoroquinolones (97%), and ceftriaxone (96.8%). About 68% of respondents had prescribed antibiotics from the World Health Organization reserve group. Prior AMR training, professional rank, department, and hospital of practice were independently associated with good KAPPr., Conclusions: Our study suggests gaps in knowledge and attitude of APR and AMR with inappropriate prescriptions of antibiotics among physicians practicing in tertiary hospitals in Nigeria. Nigeria's NAPAR should also target establishment and improvement of ASP in hospitals and address institutional, educational, and professional factors that may influence emergence of AMR in Nigeria.

Large doses of ionizing radiation can damage human tissues. Therefore, there is a need to investigate the radiation effects as well as identify effective and non-toxic radioprotectors. This study evaluated the radioprotective effects of Kelulut honey (KH) from stingless bee ( Trigona sp.) on zebrafish ( Danio rerio ) embryos. Viable zebrafish embryos at 24 hpf were dechorionated and divided into four groups, namely untreated and non-irradiated, untreated and irradiated, KH pre-treatment and amifostine pre-treatment. The embryos were first treated with KH (8 mg/mL) or amifostine (4 mM) before irradiation at doses of 11 Gy to 20 Gy using gamma ray source, caesium-137 ( 137 Cs). Lethality and abnormality analysis were performed on all of the embryos in the study. Immunohistochemistry assay was also performed using selected proteins, namely γ-H2AX and caspase-3, to investigate DNA damages and incidences of apoptosis. KH was found to reduce coagulation effects at up to 20 Gy in the lethality analysis. The embryos developed combinations of abnormality, namely microphthalmia (M), body curvature and microphthalmia (BM), body curvature with microphthalmia and microcephaly (BMC), microphthalmia and pericardial oedema (MO), pericardial oedema (O), microphthalmia with microcephaly and pericardial oedema (MCO) and all of the abnormalities (AA). There were more abnormalities developed from 24 to 72 h (h) post-irradiation in all groups. At 96 h post-irradiation, KH was identified to reduce body curvature effect in the irradiated embryos (up to 16 Gy). γ-H2AX and caspase-3 intensities in the embryos pre-treated with KH were also found to be lower than the untreated group at gamma irradiation doses of 11 Gy to 20 Gy and 11 Gy to 19 Gy, respectively. KH was proven to increase the survival rate of zebrafish embryos and exhibited protection against organ-specific abnormality. KH was also found to possess cellular protective mechanism by reducing DNA damage and apoptosis proteins expression.

Heterocyclic amines (HCAs) are carcinogenic food toxicants formed in cooked meats, which may increase the risk of cancer development in humans. Therefore, in this study, the effect of stingless bee honey from different botanical origins on the formation of HCAs in grilled beef satay was investigated. HCAs concentration in grilled beef satay was determined by using high performance liquid chromatography (HPLC). In total, six of the most toxigenic HCAs representing aminoimidazo-azaarenes (AIAs) (MeIQx, 4,8-DiMeIQx, and PhIP) and amino carbolines (norharman, harman, and AαC) groups were identified in all the beef samples investigated. A significant reduction in HCAs was observed in grilled beef marinated in honey as compared to beef samples marinated in table sugar (control), in which the reduction of 95.14%, 88.45%, 85.65%, and 57.22% was observed in gelam, starfruit, acacia, and Apis honey marinades, respectively. According to the partial least squares regression (PLS) model, the inhibition of HCAs in grilled beef was shown to be significantly correlated to the antioxidant activity (IC 50 ) of the honey samples. Therefore, the results of this study revealed that the addition of stingless bee honey could play an important role in reducing HCAs in grilled beef.

Introduction: Fresh frozen plasma (FFP) is a blood component containing functional quantities of all coagulation factors stored at -18°C or below. FFP has to be thawed and transfused as soon as possible to prevent the loss of certain coagulation factor activities and to minimise microbial contamination., Materials and Methods: Thirty units of FFP kept at -20°C were thawed using a 37°C water bath and immediately sampled for baseline Factor II (FII), Factor VIII (FVIII) and fibrinogen activity levels and sterility testing. Each unit was then divided into two smaller bags (i.e. Bag I and Bag II) and kept at 4°C. At 6 hours and Day 3, representative samples were taken from Bag I for coagulation factor activity assays, while at Day 5 representative samples were taken from Bag II for coagulation factor activity assays and sterility testing., Results: FII activities at the four time points were 73.43%, 73.73%, 71% and 69.8%, respectively, while FVIII activities were 177.63%, 144.37%, 80.8% and 70.97%, respectively. Fibrinogen levels at the four time points were 3.24 g/L, 3.24 g/L, 3.21 g/L and 3.20 g/L, respectively. All samples were free from microbial contamination even at Day 5., Conclusion: The mean reduction in FII and fibrinogen activities on Day 5 was 5% and 1%, respectively. However, FVIII activity declined significantly by approximately 60% at Day 5. Despite these reductions, thawed plasma stored for up to 5 days at 4°C is still suitable for use as the coagulation factor activity levels still exceed the minimum release criteria recommended in quality assurance regulations.

Stingless bee honey produced by Heterotrigona itama from different botanical origins was characterised and discriminated. Three types of stingless bee honey collected from acacia, gelam, and starfruit nectars were analyzed and compared with Apis mellifera honey. The results showed that stingless bee honey samples from the three different botanical origins were significantly different in terms of their moisture content, pH, free acidity, total soluble solids, colour characteristics, sugar content, amino acid content and antioxidant properties. Stingless bee honey was significantly different from Apis mellifera honey in terms of physicochemical and antioxidant properties. The amino acid content was further used in the chemometrics analysis to evaluate the role of amino acid in discriminating honey according to botanical origin. Partial least squares-discriminant analysis (PLS-DA) revealed that the stingless bee honey was completely distinguishable from Apis mellifera honey. Notably, a clear distinction between the stingless bee honey types was also observed. The specific amino acids involved in the distinction of honey were cysteine for acacia and gelam, phenylalanine and 3-hydroxyproline for starfruit, and proline for Apis mellifera honey. The results showed that all honey samples were successfully classified based on amino acid content.

Background: Low-income and middle-income countries (LMICs) are under-represented in reports on the burden of antimicrobial resistance. We aimed to quantify the clinical effect of carbapenem resistance on mortality and length of hospital stay among inpatients in LMICs with a bloodstream infection due to Enterobacteriaceae., Methods: The PANORAMA study was a multinational prospective cohort study at tertiary hospitals in Bangladesh, Colombia, Egypt, Ghana, India, Lebanon, Nepal, Nigeria, Pakistan, and Vietnam, recruiting consecutively diagnosed patients with carbapenem-susceptible Enterobacteriaceae (CSE) and carbapenem-resistant Entero-bacteriaceae (CRE) bloodstream infections. We excluded patients who had previously been enrolled in the study and those not treated with curative intent at the time of bloodstream infection onset. There were no age restrictions. Central laboratories in India and the UK did confirmatory testing and molecular characterisation, including strain typing. We applied proportional subdistribution hazard models with inverse probability weighting to estimate the effect of carbapenem resistance on probability of discharge alive and in-hospital death, and multistate modelling for excess length of stay in hospital. All patients were included in the analysis., Findings: Between Aug 1, 2014, and June 30, 2015, we recruited 297 patients from 16 sites in ten countries: 174 with CSE bloodstream infection and 123 with CRE bloodstream infection. Median age was 46 years (IQR 15-61). Crude mortality was 20% (35 of 174 patients) for patients with CSE bloodstream infection and 35% (43 of 123 patients) for patients with CRE bloodstream infection. Carbapenem resistance was associated with an increased length of hospital stay (3·7 days, 95% CI 0·3-6·9), increased probability of in-hospital mortality (adjusted subdistribution hazard ratio 1·75, 95% CI 1·04-2·94), and decreased probability of discharge alive (0·61, 0·45-0·83). Multilocus sequence typing showed various clades, with marginal overlap between strains in the CRE and CSE clades., Interpretation: Carbapenem resistance is associated with increased length of hospital stay and mortality in patients with bloodstream infections in LMICs. These data will inform global estimates of the burden of antimicrobial resistance and reinforce the need for better strategies to prevent, diagnose, and treat CRE infections in LMICs., Funding: bioMérieux., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Adenosine-to-inosine RNA editing is one of the most common types of RNA editing, a posttranscriptional modification made by special enzymes. We present a proteomic study on this phenomenon for Drosophila melanogaster. Three proteome data sets were used in the study: two taken from public repository and the third one obtained here. A customized protein sequence database was generated using results of genome-wide adenosine-to-inosine RNA studies and applied for identifying the edited proteins. The total number of 68 edited peptides belonging to 59 proteins was identified in all data sets. Eight of them being shared between the whole insect, head, and brain proteomes. Seven edited sites belonging to synaptic vesicle and membrane trafficking proteins were selected for validation by orthogonal analysis by Multiple Reaction Monitoring. Five editing events in cpx, Syx1A, Cadps, CG4587, and EndoA were validated in fruit fly brain tissue at the proteome level using isotopically labeled standards. Ratios of unedited-to-edited proteoforms varied from 35:1 ( Syx1A) to 1:2 ( EndoA). Lys-137 to Glu editing of endophilin A may have functional consequences for its interaction to membrane. The work demonstrates the feasibility to identify the RNA editing event at the proteome level using shotgun proteomics and customized edited protein database.

Melting aluminium waste to produce a secondary bulk material is such an energy-intensive recycling technique that it also indirectly threatens the environment. Hot press forging is introduced as an alternative. Mixing the waste with another substance is a proven practice that enhances the material integrity. To cope with the technology revolution, a finite element is utilised to predict the behaviour without a practical trial. Utilising commercial software, DEFORM 3D, the conjectures were demonstrated scientifically. The flow stress of the material was modified to suit the material used in the actual experiment. It is acknowledged that the stress⁻strain had gradually increased in each step. Due to the confined forming space, the temperature decreased by ~0.5% because the heat could not simply vacate the area. A reduction of ~10% of the flesh observed in the simulation is roughly the same as in the actual experiment. Above all, the simulation abides by the standards and follows what has been done previously. Through the finite element utilisation, this study forecasted the performance of the recycled composite. The results presented may facilitate improvement of the recycling issue and conserve the environment for a better future.

Background and Purpose: Malaysian National Quit Smoking Program had proposed to integrate smoking cessation counseling skills into all relevant healthcare curricula as one of its strategies to increase the number of Malaysians giving up smoking. More effective implementation of the curricula can be facilitated by further understanding the factors influencing students' intention in terms of providing smoking cessation counseling. This study, guided by Integrated Behavior Model (IBM), aimed to explore the factors which influenced pharmacy undergraduates in providing smoking cessation counseling., Educational Activity and Setting: Following the elicitation study, the IBM-guided questionnaire was developed and distributed to students from two pharmacy schools which agreed to participate, each representing public and private institutions., Findings: A total of 387 pharmacy students participated yielding a 83% response rate. Multiple regression analysis revealed that all three, namely, attitude (23%), perceived norm (16%), and personal agency (16%) were significant predictors of students' intention. Further analysis revealed 'experiential attitude', a component of attitude as the strongest predictor. In other words, students who felt more comfortable had higher intention to provide smoking cessation counseling., Summary: An implication of this study is that tobacco-related curricula with an emphasis to enhance students' comfort level in providing counseling would be of value for these future pharmacists in terms of their intention as well as actual provision of smoking cessation counseling through the mediation of "experiential attitude" and personal agency., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The photo-degradation of nutrients in stormwater in photocatalytic reactor wet detention pond using nano titanium dioxide (TiO2) in concrete was investigated in a scale model as a new stormwater treatment method. Degradation of phosphate and nitrate in the presence of nano-TiO2 under natural ultra violet (UV) from tropical sunlight was monitored for 3 weeks compared with normal ponds. Two types of cement, including ordinary Portland and white cement mixed with TiO2 nano powder, were used as a thin cover to surround the body of the pond. Experiments with and without the catalyst were carried out for comparison and control. Average Anatase diameter of 25 nm and Rutile 100 nm nano particles were applied at three different mixtures of 3, 10 and 30% weight. The amounts of algae available orthophosphate and nitrate, which cause eutrophication in the ponds, were measured during the tests. Results revealed that the utilization of 3% up to 30% weight nano-TiO2 can improve stormwater outflow quality by up to 25% after 48 h and 57% after 3 weeks compared with the control sample in normal conditions with average nutrient (phosphate and nitrate) removal of 4% after 48 h and 10% after 3 weeks.

Multivariate analysis of thin-layer chromatography (TLC) images was modeled to predict antioxidant activity of Pereskia bleo leaves and to identify the contributing compounds of the activity. TLC was developed in optimized mobile phase using the 'PRISMA' optimization method and the image was then converted to wavelet signals and imported for multivariate analysis. An orthogonal partial least square (OPLS) model was developed consisting of a wavelet-converted TLC image and 2,2-diphynyl-picrylhydrazyl free radical scavenging activity of 24 different preparations of P. bleo as the x- and y-variables, respectively. The quality of the constructed OPLS model (1 + 1 + 0) with one predictive and one orthogonal component was evaluated by internal and external validity tests. The validated model was then used to identify the contributing spot from the TLC plate that was then analyzed by GC-MS after trimethylsilyl derivatization. Glycerol and amine compounds were mainly found to contribute to the antioxidant activity of the sample. An alternative method to predict the antioxidant activity of a new sample of P. bleo leaves has been developed., (Copyright © 2015 John Wiley & Sons, Ltd.)

Toxic cyanobacteria blooms are increasing in magnitude and frequency worldwide. However, this issue has not been adequately addressed in Malaysia. Therefore, this study aims to better understand eutrophication levels, cyanobacteria diversity, and microcystin concentrations in ten Malaysian freshwater lakes. The results revealed that most lakes were eutrophic, with total phosphorus and total chlorophyll-a concentrations ranging from 15 to 4270 µg L(-1) and 1.1 to 903.1 µg L(-1), respectively. Cyanobacteria were detected in all lakes, and identified as Microcystis spp., Planktothrix spp., Phormidium spp., Oscillatoria spp., and Lyngbya spp. Microcystis spp. was the most commonly observed and most abundant cyanobacteria recorded. Semi-quantitative microcystin analysis indicated the presence of microcystin in all lakes. These findings illustrate the potential health risk of cyanobacteria in Malaysia freshwater lakes, thus magnifying the importance of cyanobacteria monitoring and management in Malaysian waterways.

The descriptive distribution and phylogeny of feline coronaviruses (FCoVs) were studied in cats suspected of having feline infectious peritonitis (FIP) in Malaysia. Ascitic fluids and/or biopsy samples were subjected to a reverse transcription polymerase chain reaction (RT-PCR) targeted for a conserved region of 3'untranslated region (3'UTR) of the FCoV genome. Eighty nine percent of the sampled animals were positive for the presence of FCoV. Among the FCoV positive cats, 80% of cats were males and 64% were below 2 years of age. The FCoV positive cases included 56% domestic short hair (DSH), 40% Persian, and 4% Siamese cats. The nucleotide sequences of 10 selected amplified products from FIP cases were determined. The sequence comparison revealed that the field isolates had 96% homology with a few point mutations. The extent of homology decreased to 93% when compared with reference strains. The overall branching pattern of phylogenetic tree showed two distinct clusters, where all Malaysian isolates fall into one main genetic cluster. These findings provided the first genetic information of FCoV in Malaysia.

The objective of this article is to study the influence of exposure and socio-economic variables on the blood lead level of Malaysian school children. Data on respirable lead and blood lead of 346 school children were obtained from Kuala Lumpur (urban), Kemaman (semi-urban) and Setiu (rural). Respirable lead and blood lead were highest for Kuala Lumpur (95 ng/m3 and 5.26 micrograms/dL) followed by Kemaman (27 ng/m3 and 2.81 micrograms/dL) and Setiu (15 ng/m3 and 2.49 micrograms/dL), and the differences were statistically significant. The percentage of school children with excessive blood lead of 10 micrograms/dL or greater was 6.36% overall, and highest for Kuala Lumpur (11.73%). Regression analyses show that urban children are at higher risk of exhibiting excessive blood lead levels. Kuala Lumpur's school children have a 25 times greater risk of having excessive blood lead levels when compared to Kemaman's and Setiu's school children. Respirable and blood lead were correlated (r = 0.999, p = 0.021). Urban school children acquire higher blood lead levels than their rural and semi-urban counterparts, even after controlling for age, sex, parents' education and income levels. In conclusion, it is time that lead in the Malaysian environment and population be monitored closely, especially its temporal and spatial variability. Only then can a comprehensive preventive strategy be implemented.