Search

Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks.

Background:he number of patients on warfarin therapy is rising steadily. Although warfarin is beneficial, it carries a high risk of bleeding, especially if the international normalized ratio (INR) values exceed 3.0. Currently, no warfarin initiation regimens have been developed for the Asian population, especially for Malaysians. Objective:This article describes the efficacy and safety of a new initiation regimen for warfarin among warfarin-naive patients. Method:Data were retrospectively collected from the ambulatory and inpatient settings. Results:A total of 165 patients who each had a target INR of 2.0 to 3.0 were included in the study. The mean age was 57.2 years and 94 patients were male. A total of 108 patients used Regimen 1 (5 mg/5 mg/3mg) and the rest of the patients used Regimen 2 (5 mg/3 mg/3 mg). Most patients used warfarin either for atrial fibrillation (52.1%) or for venous thromboembolism (29.7%). Overall, 88 of the patients had INR values above 50% from the baseline on Day 4. Additionally, 13 patients had INR values of >3.2, which required withholding and lower dose of warfarin. The predicted weekly maintenance warfarin dose (23 ± 0.5 mg/week) was found to have correlated closely with the actual maintenance dose (22.8 ± 0.5 mg/week; r2= 0.75). Nearly two thirds (70.3%) of the patients achieved the target INR on Day 11. Conclusion:The warfarin initiation regimens in this study was simple, safe, and suitable to be used in both ambulatory and inpatient settings for managing warfarin therapy.

The treatment of palm oil mill effluent (POME) has always been the topic of research in Malaysia due to the high concentration of total suspended solid (TSS) and oil and grease (O&G) ranges from 28 846 to 30 920 mg/L and 5614 to 8812 mg/L, respectively. Additionally, the release of methane gas during the treatment of POME in all of the palm oil mills has been the major contributor to greenhouse gas (GHG) effect. The main aim of this work is to evaluate the performance of the pilot-plant integrated anaerobic–aerobic bioreactor (IAAB) for POME treatment at two different phases: (a) startup and (b) long-term performance evaluation from an organic loading rate (OLR) of 10.5 to 32.5 gCOD/(L·day). Startup of the pilot-plant IAAB was successfully accomplished in 24 days with overall removal efficiencies in terms of biochemical oxygen demand (BOD), chemical oxygen demand (COD), and total suspended solid (TSS) of at least 90% at the OLR of 8.0 gCOD/(L·day). The pilot-plant IAAB achieved high BOD, COD, and TSS removal efficiencies of more than 99% for OLR up to 30.0 gCOD/(L·day) with methane yield ranges from 0.0406 LCH4/gCODremovedto 0.1312 LCH4/gCODremoved. The effluent quality remained stable with BOD of 16–107 mg/L with a high percent of compliance with the discharge limit of 100 mg/L. The coupling of the Grau second-order and Stover–Kincannon models (anaerobic system) with the Stover–Kincannon model (aerobic system) will completely define the pilot-plant IAAB system. This pilot-plant research will provide valuable data and experiences required to design and commission a full-scale IAAB.

Using micropatterned epithelial tissues, we found that mechanical stress gradients that arise from the intercellular transmission of cytoskeletal tension lead to the opening of connexin hemichannels, causing local membrane depolarization, nuclear translocation of Yap/Taz, and cell proliferation.

The authors describe a patient with native knee infection caused by Candida viswanathii. This is the fi rst report of an osteoarticular infection due to this rare candida. The patient was treated with two arthroscopic washouts and 16 months of anti-fungal therapy with full recovery. The treatment success was multifactorial owing to a prompt molecular identification of the pathogen, adequate source control with arthrotomies, susceptibility directed anti-fungal therapy, therapeutic drug monitoring of voriconazole, and close follow-up.An elderly lady was diagnosed in 2015 with septic arthritis and osteomyelitis of the knee caused by Candida viswanathii. This is the first report of a nonmeningitic, noncandidemic osteoarticular infection due to this rare Candidasince the first 2 isolations in cerebrospinal fluid in 1959 and 1976, respectively. She was successfully treated with 2 repeat arthroscopic washouts and 16 months of susceptible antifungal therapy with full recovery. The contributing factors of this successful treatment include prompt molecular identification of this rare Candidaspecies, adequate source control with arthrotomies, susceptibility directed antifungal therapy, therapeutic drug monitoring of voriconazole, and close follow-up of our patient. To our understanding, this is also the first reported case of invasive C. viswanathiiinfection with detailed clinical presentation, treatment method, and treatment response described.

To what extent could “Big Data” predict the results of the 2016 U.S. presidential election better than more conventional sources of aggregate measures? To test this idea, the present research used Google search trends versus other forms of state-level data (i.e., both behavioral measures like the incidence of hate crimes, hate groups, and police brutality and implicit measures like Implicit Association Test (IAT) data) to predict each state’s popular vote for the 2016 presidential election. Results demonstrate that, when taken in isolation, zero-order correlations reveal that prevalence of hate groups, prevalence of hate crimes, Google searches for racially charged terms (i.e., related to White supremacy groups, racial slurs, and the Nazi movement), and political conservatism were all significant predictors of popular support for Trump. However, subsequent hierarchical regression analyses show that when these predictors are considered simultaneously, only Google search data for historical White supremacy terms (e.g., “Adolf Hitler”) uniquely predicted election outcomes earlier and beyond political conservatism. Thus, Big Data, in the form of Google search, emerged as a more potent predictor of political behavior than other aggregate measures, including implicit attitudes and behavioral measures of racial bias. Implications for the role of racial bias in the 2016 presidential election in particular and the utility of Google search data more generally are discussed.

The aim of this study is to investigate the rumen ecology and feed digestion in Formosan Reeves’ muntjac (Muntiacus reevesi micrurus). We also observed the effect of captive environment on animal digestive physiology by comparing the characteristics of gastrointestinal tract and tissue samples of ruminal papillae between captive and wild muntjac. Results revealed that the pH value of rumen fluids of captive muntjac was 6.44 and the concentration of volatile fatty acid, which was lower than that of the domestic animal. The rumen total bacteria count was 1.35×108colony counts/mL rumen fluids. The percentage of Isotrichidae in total protozoa population was lower than 20%, whereas Ophryoscolecidae was greater than 80%. The ratio of intestinal length to body length was approximately 13.9:15.1 which was similar to the concentrate selector. The morphology of ruminal papillae showed distinct difference between captive and wild muntjacs, and the length of small intestinal tract tended to be longer in captive muntjac, suggesting that morphology of ruminal papillae could be related to the dietary difference between captive and wild muntjacs.

Hyperkalaemia has been reported with high‐dose trimethoprim (20 mg/kg/day) and standard‐dose trimethoprim (6 mg/kg/day) plus sulfamethoxazole use. To investigate changes in plasma potassium concentrations in patients prescribed standard‐dose trimethoprim 300 mg daily for urinary tract infections. A retrospective cohort study of hospital patients with urinary tract infections treated with trimethoprim or other antibacterials (control group) for more than 5 days. Plasma potassium concentration, creatinine and urea were compared at baseline and at the completion of treatment. There were 31 patients in the trimethoprim group and 65 patients in the control group. End–of–therapy mean plasma potassium concentrations increased significantly from baseline in the trimethoprim group (4.2 ± 0.4 mmol/L to 4.5 ± 0.5 mmol/L; p = 0.002) but not in the control group. End–of–therapy mean plasma potassium concentrations were also higher in the trimethoprim group (4.5 ± 0.5 mmol/L vs 4.2 ± 0.5 mmol/L; p = 0.007). 65% of the trimethoprim group developed end–of–therapy hyperkalaemia versus 39% of the control group. Mean creatinine concentration in the trimethoprim group increased by an average of 21% from baseline but did not change in the control group. The trimethoprim group showed no change in mean urea concentration but a decrease was noted in the control group. Treating urinary tract infections with trimethoprim 300 mg daily for more than 5 days was associated with an increase in plasma potassium concentration.

We have developed a highly pure, self-adjuvanting, triepitopic Group A Streptococcal vaccine based on the lipid core peptide system, a vaccine delivery system incorporating lipidic adjuvant, carrier, and peptide epitopes into a single molecular entity. Vaccine synthesis was performed using native chemical ligation. Due to the attachment of a highly lipophilic adjuvant, addition of 1% (w/v) sodium dodecyl sulfate was necessary to enhance peptide solubility in order to enable ligation. The vaccine was synthesized in three steps to yield a highly pure product (97.7% purity) with an excellent overall yield. Subcutaneous immunization of B10.BR (H-2k) mice with the synthesized vaccine, with or without the addition of complete Freund's adjuvant, elicited high serum IgG antibody titers against each of the incorporated peptide epitopes.

Group A streptococcus (GAS) is responsible for causing many clinical complications including the relatively benign streptococcal pharyngitis and impetigo. However, if left untreated, these conditions may lead to more severe diseases such as rheumatic fever (RF) and rheumatic heart disease (RHD). These diseases exhibit high morbidity and mortality, particularly in developing countries and in indigenous populations of affluent countries. As RF and RHD only ever occur following GAS infection, a vaccine offers promise for their prevention. As such, we have investigated the use of the lipid-core peptide (LCP) system for the development of multi-valent prophylactic GAS vaccines. The current study has investigated the capacity of this system to adjuvant up to four different GAS peptide epitopes. Presented are the synthesis and immunological assessment of tetra-valent and tri-valent GAS LCP systems. We demonstrated their capacity to elicit systemic IgG antibody responses in B10.BR mice to all GAS peptide epitopes. The data also showed that the LCP systems were self-adjuvanting. These findings are particularly encouraging for the development of multi-valent LCP-based GAS vaccines.

Petuniax hybridaHort.Vilm.-Andr. was transformed with boers, a mutatedallele of BOERS, an ethylene receptor sensor gene ofBrassicaoleracea.boerswas obtained by removing anEcoRI cutting site with a silent mutation at Gly-521 andintroducing a point mutation at Ile-62, replacing isoleucine withphenylalanine. Transformation was Agrobacterium tumefaciensmediated.Hygromycin resistant regenerants were tentatively confirmed as transformants byPCR's for HPHand boersand moredefinitively by Southern hybridization of genomic DNA with pBOERS4421. Flowersof transgenic plants retained turgidity and pigmentation considerably longerthan those of untransformed controls, whether left undisturbed on plants orexcised and placed in water. Furthermore, flowers were unaffected by exposureto exogenous ethylene. Excised shoots of transgenic plants released considerablymore ethylene than those of untransformed plants. Transformed plants alsoproduced apparently larger flowers. Unexpectedly higher mortality was observed,suggesting that the ethylene insensitive petunia plants were also lower indisease resistance.

The stability of unsaturated fatty acids to oxidation was monitored by following gas chromatographic (GC) analyses of headspace volatiles in comparison to changes in polyunsaturated fatty acids (PUFA) and increases in malonaldehydeviathe 2-thiobarbituric (TBA) assay. Pure standards of linoleic acid (Lo) and n-3 fatty acids [eicosapentaenoic (EPA) and docosahexaenoic acid (DHA)] were added to headspace vials, equilibrated in air for 10 min, followed by heating at 80°C in teflon-capped vials for different time intervals. Headspace analysis showed increases in acetaldehyde, propenal, and propanal, corresponding to the oxidation of n-3 fatty acids, whereas hexanal production corresponded to losses of linoleic acid. The analysis of propanal by GC-headspace after only five minutes of heating appeared to be the most effective method of monitoring the oxidation of n-3 fatty acids, as indicated by correlations between TBA values and loss of PUFA. The oxidation of Lo, EPA and DHA appeared to be a function of the number of double bonds. Correlations between PUFA depletion, TBA values and volatile formation indicate that under the prescribed conditions of this experiment, GC-headspace analysis of propanal and pentane/hexanal is an excellent method for following the oxidation of selected n-3 fatty acids and linoleic acid.

The stability of unsaturated fatty acids to oxidation was monitored by following gas chromatographic (GC) analyses of headspace volatiles in comparison to changes in polyunsaturated fatty acids (PUFA) and increases in malonaldehydeviathe 2-thiobarbituric (TBA) assay. Pure standards of linoleic acid (Lo) and n-3 fatty acids [eicosapentaenoic (EPA) and docosahexaenoic acid (DHA)] were added to headspace vials, equilibrated in air for 10 min, followed by heating at 80°C in teflon-capped vials for different time intervals. Headspace analysis showed increases in acetaldehyde, propenal, and propanal, corresponding to the oxidation of n-3 fatty acids, whereas hexanal production corresponded to losses of linoleic acid. The analysis of propanal by GC-headspace after only five minutes of heating appeared to be the most effective method of monitoring the oxidation of n-3 fatty acids, as indicated by correlations between TBA values and loss of PUFA. The oxidation of Lo, EPA and DHA appeared to be a function of the number of double bonds. Correlations between PUFA depletion, TBA values and volatile formation indicate that under the prescribed conditions of this experiment, GC-headspace analysis of propanal and pentane/hexanal is an excellent method for following the oxidation of selected n-3 fatty acids and linoleic acid.

Naturally acquired immunity to malaria is robust and protective against all strains of the same species of Plasmodium. This develops as a result of repeated natural infection, taking several years to develop.

Poor prognosis of most cancer patients is in part, due to limited therapeutic options. Furthermore, as chemotherapy remains the standard-of-care for several cancers, partial or lack of response remains a concern and compounding this are the adverse side effects of the treatment that severely impacts the quality of life and survival. In pursuit of improving treatment options, we have opted to investigate the unique chemical skeleton of natural compounds as anticancer therapies. In this study, from an initial screen of 31 crude methanol extracts from ~15 plant species using HL60 cells, the root extract of Brucea javanica(L.) Merr indicated the presence of bioactive compounds. Subsequent bioassay-guided purification on the root extract yielded two alkaloids canthin-6-one (1) and bruceolline J (2), which were further investigated for their bioactivity in representative human cancer lines and normal phenotypic counterparts. MTT assay demonstrated ED50values from 34.7–72.9 μM for 1and 16.0–54.0 μM for 2for the cancer cell lines panel. NP69 cells also demonstrated sensitivity to both compounds (9.3 μM and 4.5 μM). As amount of 2isolated were limiting, we focused on 1to further identify novel anticancer properties in PC3 and HeLa cancer lines. We observed at 30 μM, 1induced a G2/M phase arrest coinciding with decreased cell proliferation. Furthermore, 1was able to synergize the cytotoxic effect of cisplatin when used in combination, suggesting the potential of combination therapy for those less responsive lesions to standard chemotherapy.