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This research aims to determine the effectiveness of cassava waste and skim milk as a filler of phytogenic and probiotic blends to inhibit phtytogenic bacteria and aflatoxin. The phytogenics and probiotics blends were used in the yellow type with the composition of Galangal (Kaempferia rhizome), Temulawak (Curcuma xanthorrihiza roxb), Red Ginger (Zingiber officinale), Turmeric (Curcuma domestica val), Actinomycetes, lactic acid bacteria, photosynthetic bacteria, tempeh yeast, and fermentation fungi (Aspergillus); furthermore, the green type consists of Sambiloto (Andrographis paniculata), Betel (Piper betle), Moringa (Moringa Oliefera), Papaya (Carica papaya), actinomycetes, lactic acid bacteria, photosynthetic bacteria, tempe yeast, and fermentation fungi (Aspergillus). Each pytobiotic and probiotic in yellow and green types were filled with cassava waste and skim milk, then dried in an oven at 50 °C for 24 hours. The ratio between the combination of phytogenics and probiotics with the filler is 1:1. The inhibition was divided into four types, consisting of positive control, negative control, cassava waste, and skim milk. The inhibitory pathogenic bacteria and fungi used the Well Method. The data were analyzed using a complete randomized design. If there were a significantly different result, then the analysis of the Duncan Multiple Range Test (DMRT) would be continued. The results showed that control positive in the yellow and green type has the higher inhibitory pathogenic on salmonella, escherichia coli, and aflatoxin. However, the filler casava waste has higher inhibitory salmonella, escherichia coli, and aflatoxin compared to skim milk. The conclusion of this research showed that cassava waste is effective as a filler for phytogenic and probiotics as an inhibitory pathogenic bacteria and aflatoxin.

This study aims to evaluate the effect of the combined extraction of Andrographis paniculata and Moringa oleifera leaves as phytobiotics on the digestive microbiology of broiler chickens. The number of chickens used in this study was one hundred twenty-eight (128) chickens divided into 4 treatments, 4 replications where each replication consisted of 8 chickens. The treatments in this study were T0 (control), T1 (basal diet + 0.25% Andrographis paniculata and Moringa oleifera leaves), T2 (0.50% Andrographis paniculata and Moringa oleifera leaves), and T3 (0.75% Andrographis paniculata and Moringa oleifera leaves). The method used in this research is in vivo. Data analysis used a completely randomized design. If there is a significant difference, it is analysed using the Duncan Multiple Range Test (DMRT). The results of the study showed that the use of Andrographis paniculata and Moringa oleifera leaves had a significant effect on the number of lactic acid bacteria, Escherichia coli and Salmonella in the digestion of broiler chickens. T3 showed the highest number of lactic acid bacteria compared to other treatments, while T3 showed the lowest number of E. coli and Salmonella. The use of Andrographis paniculata 0.75% and Moringa oleifera leaves had a positive influence on the number of lactic acid bacteria in the digestion of broiler chickens.

ABSTRAK Jeringau merah (Acorus sp) dan jeringau putih (Acorus calamus) merupakan tanaman dari famili Araceae yang rimpangnya dijadikan bahan obat-obatan. Antioksidan merupakan senyawa yang dapat menghambat reaksi oksidasi, dengan mengikat radikal bebas dan molekul yang sangat reaktif sehingga kerusakan sel akan dihambat. Penelitian ini bertujuan untuk menganalisis senyawa bioaktif, aktivitas antioksidan dan profil asam lemak pada jeringau merah dan jeringau putih sehingga dapat digunakan sebagai bahan tambahan dalam makanan, pakan serta sebagai sumber antioksidan alami. Bahan yang digunakan dalam penelitian ini adalah rimpang jeringau merah dan jeringau putih. Hasil analisis menunjukan kandungan flavonoid dan aktivitas antioksidan (IC50) pada jeringau merah masing-masing sebesar 33.76 % b/b dan 0.22 mg/ml sedangkan tepung rimpang jeringau putih sebesar 3.84 % b/b dan 0.49 mg/ml. Jenis asam lemak yang dominan menyusun fraksi lipida rimpang jeringau merah dan jeringau putih adalah laurat dan palmitat (unsaturated fatty acid). Asam lemak jenuhnya terdiri dari 7 macam asam lemak dengan asam palmitat sebagai komponen utamanya. Sementara itu, pada rimpang jeringau merah mengandung asam linoleat, sedangkan pada jeringau putih tidak ada. Penelitian ini menunjukkan bahwa rimpang jeringau merah dan jeringau putih dapat digunakan sebagai bahan tambahan dalam makanan, pakan, serta sebagai sumber antioksidan alami ABSTRACT Red cypress (Acorus sp) and white jeringau (Acorus calamus) are plants of the Araceae family whose rhizome is made into medicinal materials. Antioxidants are compounds that can inhibit oxidation reactions, by binding to free radicals and highly reactive molecules so that cell damage will be inhibited. This study aims to analyze bioactive compounds, antioxidant activity and fatty acid profiles in red and white jinks and white jeringau so it can be used as an additive in food, feed as well as a source of natural antioxidants. The materials used in this study are red jisan rhizome and white jeringau. The results showed that flavonoid content and antioxidant activity (IC50) in red jeringau were 33.76% w / w and 0.22 mg /ml respectively, while white jengese rhizome flour was 3.84% w / w and 0.49 mg / ml. The dominant types of fatty acids that make up the fraction of red jelly rhizome and white jeringau are lauric and palmitate (unsaturated fatty acid). The saturated fatty acid consists of seven kinds of fatty acids with palmitic acid as its main component. Meanwhile, the red jisanau rhizome contains linoleic acid while in white jinkau not exist. This study shows that red jisan rhizome and white jinkau can be used as additive in food, feed as well as natural source of antioxidant

Magnetorheological greases (MRGs) is a viscoelastic suspension comprised of carbonyl iron (CI) particles in a thixotropic medium; grease, which able to solve the instability problem that occurs in oil medium like MRFs. The primary purpose introduction of superparamagnetic nanoparticles γ-Fe2O3 in MRGs suspension is to investigate the effect of additives toward MRGs characteristics. Two types of MRGs suspension with and without nanoparticles γ-Fe2O3 were prepared in the same CI particles concentration for comparison purpose. It was observed that MRGs with incorporated of 1 wt% nanoparticles γ-Fe2O3 showed an increment regarding magnetic properties. In the meantime, the off-state viscosity of MRGs containing nanoparticles γ-Fe2O3 was reduced, however, increased during on-state condition. This fact indicates that the interspaces between CI particles are filled by the nanoparticles γ-Fe2O3. Therefore, the introduction of the nanoparticles indirectly improved the MRGs properties.

The polymerization shrinkage of composite resins may affect negatively the clinical outcome of the restoration. Extensive research has been carried out to develop new formulations of composite resins in order to provide good handling characteristics and some dimensional stability during polymerization. The purpose of this study was to analyze, in vitro, the magnitude of the volumetric polymerization shrinkage of 7 contemporary composite resins (Definite, Suprafill, SureFil, Filtek Z250, Fill Magic, Alert, and Solitaire) to determine whether there are differences among these materials. The tests were conducted with precision of 0.1 mg. The volumetric shrinkage was measured by hydrostatic weighing before and after polymerization and calculated by known mathematical equations. One-way ANOVA (a or = 0.05) was used to determine statistically significant differences in volumetric shrinkage among the tested composite resins. Suprafill (1.87±0.01) and Definite (1.89±0.01) shrank significantly less than the other composite resins. SureFil (2.01±0.06), Filtek Z250 (1.99±0.03), and Fill Magic (2.02±0.02) presented intermediate levels of polymerization shrinkage. Alert and Solitaire presented the highest degree of polymerization shrinkage. Knowing the polymerization shrinkage rates of the commercially available composite resins, the dentist would be able to choose between using composite resins with lower polymerization shrinkage rates or adopting technical or operational procedures to minimize the adverse effects deriving from resin contraction during light-activation.

Objective: To evaluate the biocompatibility of camphoratedparamonochlorophenol (CMCP) at a proportion of 3.5:6.5 andcamphorate paramonochlorophenol associated to calcium hydroxide(CMCP+Ca(OH)2) in rat subcutaneous tissue, and the antimicrobialpotential of these medications against some microorganisms.Method: Ten Wistar rats were anesthetized and received anintravenous injection of Evan’s blue dye followed by inoculation of0.1 mL of the tested drugs in the dorsal region. The amount ofreleased dye bound to plasma proteins was evaluated underspectrophotometry. The antimicrobial activity of the substancesagainst S. aureus, S. mutans, B. subtilis and C. albicans wasverified by measuring the zones of bacterial growth inhibition usingthe agar diffusion test.Results: The mean optical density values for CMCP andCMCP+Ca(OH)2 were 0.325±0.025 (moderate reaction) and0.211±0.040 (mild reaction), respectively. The measurements ofthe zones of bacterial growth inhibition were as follows: CMCP =7.29 mm and CMCP+Ca(OH)2 = 7.29 mm for S. aureus; CMCP = 8.57mm and CMCP+Ca(OH)2 = 7.0 mm for S. mutans; CMCP = 8.57 mmand CMCP+Ca(OH)2 = 7.43 mm for B. subtilis; and CMCP - 8.71 mmand CMCP+Ca(OH)2 - 8.29 mm para C. albicans.Conclusion: The obtained data indicated that CMCP was moreirritating than CMCP+Ca(OH)2, while no statistically significantdifference was observed between the tested substances regardingtheir antimicrobial activity (ANOVA).

Objectives:  This study aimed to establish the cephalometric norms of H angle soft tissue and H angle hard tissue of Malaysian Malay adult females, and to evaluate the correlation between H angles and visual perception in skeletal Class I Malay adult females., Materials and Methods:  Eighty-five lateral cephalograms of skeletal Class I (mean ANB value = 3.15 ± 0.77) Malaysian Malay female patients aged 20 to 40 years (mean age = 28.6 ± 5.86 degrees) taken from October 2017 to December 2021 were measured for H angle soft tissue and H angle hard tissue. Twenty silhouettes were then converted from cephalometric films and were rated according to facial convexity/concavity by 20 laypersons, with re-evaluation after 2 weeks for intra- and interexaminer reliabilities., Results:  The means of the H angle soft tissue and H angle hard tissue were 15.75 ± 4.16 degrees and 11.64 ± 4.71 degrees, respectively. The intraexaminer reliability test for visual perception ranged from -0.89 to 0.99 indicating poor to excellent reliability, whereas the interexaminer reliability test was 0.82 indicating good reliability. A highly statistically significant association between the H angle soft tissue and H angle hard tissue ( r  = 0.938; p  < 0.01) was found. There was no correlation between H angles and visual perception., Conclusion:  The cephalometric norms of H angle hard tissue and H angle soft tissue in the Malaysian Malay female population were established: 11.64 degrees (±4.71 degrees) and 15.75 degrees (±4.16 degrees), respectively. There was a strong correlation between H angle soft tissue and H angle hard tissue among skeletal Class I Malay adult females. There was no correlation between H angles and the visual perception of laypersons., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

This cross-sectional study explores caregivers' perceptions of feeding/eating difficulties in persons living with dementia, their support provisions, and the associated burdens. Cognitive decline, behavioral symptoms, and physical issues contribute to the deterioration of feeding/eating activities in people with dementia. Inadequate support during mealtimes has adverse consequences. This study includes 31 caregivers who completed an online questionnaire with three sections: sociodemographic information, feeding/eating problems and required support for individuals with dementia, and caregiver burden and distress. The questions on feeding and eating problems were adapted from the Appetite and Eating Habits Questionnaire (APEHQ). The results show that nearly all persons living with dementia had symptoms of feeding/eating problems, requiring caregiver support, ranging from verbal assistance to full physical assistance. The caregivers reported high distress, which was positively correlated with dementia severity. The findings emphasize the importance of raising caregiver awareness about dementia's impact on eating behavior, identifying effective mealtime care strategies, meeting nutritional needs, and emphasizing personal self-care. This research provides insights for healthcare professionals to develop targeted interventions, alleviate caregiver burden, improve mealtime experiences, and ensure adequate nutrition for persons living with dementia.

The red palm weevil (RPW), Rhynchophorus ferrugineus , poses a severe threat to agro-industrial crops, particularly major cultivated palm species. Infestations result in economic losses due to reduced fruit quality and yield. The entomopathogenic fungus, Metarhizium anisopliae , has shown promise as a potential biocontrol agent against the RPW. However, the use of an emulsion formulation of M. anisopliae for managing this serious insect pest has yet to be fully explored. The oil-emulsion formulation containing this entomopathogen may enhance the conidia's stability, prolong its lifetime, and reduce the impact of heat stress or UV irradiation on the fungus. Therefore, this study aimed to investigate the bioefficacy of a new oil-in-glycerol emulsion formulation on mycoinsecticidal activity against RPW adults by direct and indirect bioassays. Results showed that conidia concentration was directly proportional to the RPW mortality percentage. The LT 50 of 8.183 days was achieved by the conidial formulation against RPW, with a significantly lower LC 50 (1.910 × 10 5 conidia mL -1 ) compared to the aqueous conidia suspension (LT 50 = 8.716 days; LC 50 = 7.671 × 10 5 conidia mL -1 ). Indirect bioassays revealed that the oil-in-glycerol emulsion had a disease-spreading ability that resulted in up to 56.67% RPW mortality. A zero E-value reading indicates that the DNA sequence being studied is highly similar to that of the fungal species M. anisopliae , which has been identified in the NCBI database. Although the new emulsion formulation has improved the efficacy and pathogenicity of M. anisopliae in vitro, it is important to also consider the fungal pathogen's compatibility with other agricultural practices to prevent any loss of control efficiency in the actual usage environment.

Leptospirosis is a common zoonotic disease in tropical and subtropical countries. It is considered an emerging disease in Malaysia and is a notifiable disease. This study was conducted to characterize Malaysian isolates from human, animal and environmental samples via MLST and rrs2 sequencing in an attempt to develop a Malaysian genotypic database. An existing polymerase chain reaction (PCR)-based MLST scheme was performed to facilitate subsequent sequencing. Out of 46 extracted DNA, 36 had complete MLST profiles whereby all six genes were amplified and sequenced. Most of the pathogenic Leptospira genotypes with full MLST profiles were L. interrogans serogroup Bataviae ( n = 17), followed by L. borgpetersenii serogroup Javanica ( n = 9), L. interrogans serogroup Sejroe ( n = 2), L. interrogans serogroup Australis ( n = 2), L. kirschneri ( n = 2), L. interrogans serogroup Grippotyphosa ( n = 1) and L. interrogans serogroup Pyrogenes ( n = 3). Two samples (R3&#95;SER/17 and R4&#95;SER/17) were not closely related with any of the reference strains. For the samples with incomplete MLST profiles, leptospiral speciation was conducted through rrs2 analysis, in which four samples were identified as L. borgpetersenii , five samples were closely related to L. kmetyi and one sample was known as L. yasudae . This study shows that molecular approaches that combine both MLST and rrs2 sequencing have great potential in the comprehensive characterization of pathogenic Leptospira because they can be performed directly from cultured and clinical samples.

Background: School-based smoking cessation intervention programmes are challenging to implement and evaluate. This study aimed to explain the process of developing the Fit and Smart Adolescent Smoking Cessation Programme (FSSCP). Logic model is a visual tool that helps programme planners to create an activity action plan that suits the target group to achieve programme objectives and goals., Methods: This two-arm cluster-randomised controlled trial was implemented between January 2018 and November 2018. Six schools were selected using stratified random sampling, whereby students were purposively selected and invited. The criteria of inclusion to the programme were secondary school students (aged 13 years old-17 years old) who smoked conventional cigarettes (CC) and electronic cigarettes (EC)., Results: A total of 422 students from six schools participated in this study. Three schools were designated as intervention ( n = 250) and the other three as control schools ( n = 172). Formative evaluation of participants in the FSSCP using the logic model showed that participants were satisfied with the overall programme (91.5%), were motivated to stop smoking (90.4%) and were prevented from relapse (89.2%). The quit rate at a 3-month follow-up was 41.8%., Conclusion: The logic model supported the development of the programme, with details on the processes, dissemination activities, identification of barriers, evaluation criteria and outcomes provided., Competing Interests: Conflict of Interest None., (© Penerbit Universiti Sains Malaysia, 2022.)

In this work, bacterial cellulose (BC)-based polymer derived from a symbiotic culture of bacteria and yeast (SCOBY) are optimized as both electrodes and electrolytes to fabricate a flexible and free-standing supercapacitor. BC is a multifunction and versatile polymer. Montmorillonite (MMT) and sodium bromide (NaBr) are used to improve mechanical strength and as the ionic source, respectively. From XRD analysis, it is found that the addition of MMT and NaBr has reduced the crystallinity of the electrolyte. Most interaction within the electrolyte happens in the region of the OH band, as verified using FTIR analysis. A maximum room temperature conductivity of (1.09 ± 0.02) × 10 -3 S/cm is achieved with 30 wt.% NaBr. The highest conducting SCOBY-based electrolytes have a decompose voltage and ionic transference number of 1.48 V and 0.97, respectively. The multiwalled carbon nanotube is employed as the active material held by the fibrous network of BC. Cyclic voltammetry shows a rectangular shape CV plot with the absence of a redox peak. The supercapacitor is charged and discharged in a zig-zag-shaped Perspex plate for 1000 cycles with a decent performance.

The prognostic value of measurable residual disease (MRD) by flow cytometry in acute myeloid leukemia (AML) patients treated with non-intensive therapy is relatively unexplored. The clinical value of MRD threshold below 0.1% is also unknown after non-intensive therapy. In this study, MRD to a sensitivity of 0.01% was analyzed in sixty-three patients in remission after azacitidine/venetoclax treatment. Multivariable cox regression analysis identified prognostic factors associated with cumulative incidence of relapse (CIR), progression-free survival (PFS) and overall survival (OS). Patients who achieved MRD < 0.1% had a lower relapse rate than those who were MRD ≥ 0.1% at 18 months (13% versus 57%, p = 0.006). Patients who achieved an MRD-negative CR had longer median PFS and OS (not reached and 26.5 months) than those who were MRD-positive (12.6 and 10.3 months, respectively). MRD < 0.1% was an independent predictor for CIR, PFS, and OS, after adjusting for European Leukemia Net (ELN) risk, complex karyotype, and transplant (HR 5.92, 95% CI 1.34−26.09, p = 0.019 for PFS; HR 2.60, 95% CI 1.02−6.63, p = 0.046 for OS). Only an MRD threshold of 0.1%, and not 0.01%, was predictive for OS. Our results validate the recommended ELN MRD cut-off of 0.1% to discriminate between patients with improved CIR, PFS, and OS after azacitidine/venetoclax therapy.

Industrial crops including coconut palm and other palm species are seriously infested by red palm weevil (RPW), resulting in significant economic damage globally. Therefore, this study aimed to develop a mycoinsecticide utilizing conidia of Metarhizium anisopliae to control RPW and sought to investigate a new emulsion formulation for the influences of storage temperature and heat stress on conidia germination in an oil-in-glycerol emulsion system. The mycoinsecticide is an emulsion formulation which comprises an oil carrier, non-ionic surfactants, water, and glycerol, which was optimized by premixing the oil and non-ionic surfactant in different weight ratios (1:0, 9:1, 8:2, 7:3, 6:4, 5:5, 4: 6, 3: 7, 2:8, 1:9, and 0:1). From three selected oil-in-glycerol formulations, F25 was more stable in storage and had a smaller particle size (between 154.3 and 236.4 nm in diameter) and stable zeta potential (above + 30 mV) with low surface tension (29.83 ± 0.24 mN/m to 30.72 ± 0.11 mN/m at room temperature. Extended conidial viability was observed at 4 °C overall; the emulsion formulation maintained 12-15% conidial viability until the eighth week at room temperature. Heat of over 30 °C showed an inhibitory effect on conidial germination. This study revealed that the oil-in-glycerol formulation was stable and able to prolong conidial shelf life as compared to non-formulated conidia.

Monitoring environmental hazards and pollution control is vital for the detection of harmful toxic gases from industrial activities and natural processes in the environment, such as nitrogen dioxide (NO 2 ), ammonia (NH 3 ), hydrogen (H 2 ), hydrogen sulfide (H 2 S), carbon dioxide (CO 2 ), and sulfur dioxide (SO 2 ). This is to ensure the preservation of public health and promote workplace safety. Graphene and its derivatives, especially reduced graphene oxide (rGO), have been designated as ideal materials in gas-sensing devices as their electronic properties highly influence the potential to adsorb specified toxic gas molecules. Despite its exceptional sensitivity at low gas concentrations, the sensor selectivity of pristine graphene is relatively weak, which limits its utility in many practical gas sensor applications. In view of this, the hybridization technique through heterojunction configurations of rGO with metal oxides has been explored, which showed promising improvement and a synergistic effect on the gas-sensing capacity, particularly at room temperature sensitivity and selectivity, even at low concentrations of the target gas. The unique features of graphene as a preferential gas sensor material are first highlighted, followed by a brief discussion on the basic working mechanism, fabrication, and performance of hybridized rGO/metal oxide-based gas sensors for various toxic gases, including NO 2 , NH 3 , H 2 , H 2 S, CO 2 , and SO 2 . The challenges and prospects of the graphene/metal oxide-based based gas sensors are presented at the end of the review.

Whether albumin and bilirubin levels, platelet counts, ALBI, and ALPlat scores could be useful for the assessment of permanent liver functional deterioration after repeat liver resection was examined, and the deterioration after laparoscopic procedure was evaluated. For 657 patients with liver resection of segment or less in whom results of plasma albumin and bilirubin levels and platelet counts before and 3 months after surgery could be retrieved, liver functional indicators were compared before and after surgery. There were 268 patients who underwent open repeat after previous open liver resection, and 224 patients who underwent laparoscopic repeat after laparoscopic liver resection. The background factors, liver functional indicators before and after surgery and their changes were compared between both groups. Plasma levels of albumin ( p = 0.006) and total bilirubin ( p = 0.01) were decreased, and ALBI score ( p = 0.001) indicated worse liver function after surgery. Laparoscopic group had poorer preoperative performance status and liver function. Changes of liver functional values before and after surgery and overall survivals were similar between laparoscopic and open groups. Plasma levels of albumin and bilirubin and ALBI score could be the indicators for permanent liver functional deterioration after liver resection. Laparoscopic group with poorer conditions showed the similar deterioration of liver function and overall survivals to open group.

The effect of layering structures on mechanical and thermal hybrid bacterial cellulose (BC) sheet/Kevlar reinforced epoxy composites was investigated. The BC sheet was extracted from Nata de Coco and used as green reinforcement material hybrid with Kevlar reinforced epoxy composites. The BC/Kevlar reinforced epoxy composite was fabricated by using hand lay-up technique equipped with vacuum bagging system and the BC sheets and Kevlar layers were laminated into different layered structures. The performance of the hybrid BC/Kevlar reinforced epoxy composites was characterized through tensile test and low velocity impact according to ASTM D3039 and ASTM D7136, respectively. The thermal performance of the hybrid composites was characterized by using dynamic mechanical analysis (DMA) test. Tensile test on BC sheet composites with Kevlar and epoxy demonstrated that the addition of BC sheet in BC/Kevlar could not withstand the tensor stress by reducing the tensile stress and Young's modulus. The one layer of Kevlar which was replaced with three to six BC sheets had increased the ability to absorb impact force. The storage modulus (E') and Tan δ were significantly dependent on the number of BC sheets and its layering structure. The highest value of E' was observed when BC sheets were arranged alternately with the Kevlar layers. Different damage mechanisms associated with the number of BC sheets and its layered-structure suggested that the BC sheet was functioning as an impact energy absorber as well as strengthening fibers. This study will upsurge interest in BC reinforced composites and the development of new ideas in automotive, marine and bullet applications., Competing Interests: The authors declare no conflict of interest., (© 2022 Published by Elsevier Ltd.)

Inspired by nature, cellulose extracted from plant wastes has been explored, due to its great potential as an alternative for synthetic fiber and filler that contributes to structural performance. The drive of this study was to extract, treat, and evaluate the characteristics of rice straw (RS) ( Oryza sativa L.) cellulose as a biodegradable reinforcement to be utilized in polymer base materials. Two routes of extraction and treatment were performed via the pulping (Route 1) and chemo-mechanical methods (Route 2), in order to discover comparative characteristics of the synthesized cellulose fiber. Comprehensive characterization of RS cellulose was carried out to determine crystallinity, surface morphology, and chemical bonding properties, using X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and Fourier transform infra-red (FTIR), respectively. The XRD test results showed that the crystallinity index (CI) of cellulose powder (CP) decreased after the surface modification treatment, Route 2, from 64.50 to 50.10% CI for modified cellulose powder (MCP), due to the surface alteration of cellulose structure. From Route 1, the crystallinity of the fibers decreased up to 33.5% (dissolve cellulose, DC) after the pulp went through the surface modification and dissolution processes, resulting from the transformation of cellulose phase into para-crystalline structure. FESEM micrographs displayed a significant reduction of raw RS diameter from 7.78 µm to 3.34 µm (treated by Route 1) and 1.06 µm (treated by Route 2). The extracted and treated cellulose via both routes, which was considerably dominated by cellulose II because of the high percentage of alkaline used, include the dissolve cellulose (DC). The dissolution process, using NMMO solvent, was performed on the pulp fiber produced by Route 1. The fiber change from cellulose I to cellulose II after undergoes the process. Thus, the dissolution process maintains cellulose II but turned the pulp to the cellulose solution. The acquired characteristics of cellulose from RS waste, extracted by the employed methods, have a considerably greater potential for further application in numerous industries. It was concluded that the great achievement of extracted RS is obtained the nanosized fibers after surface modification treatment, which is very useful for filler in structural composite applications.

Introduction: Decisions regarding whether advanced cancer patients should be admitted to the ICU are based on a complex suite of considerations, including short- and long-term prognosis, quality of life, and therapeutic options to treat cancer. We aimed to describe demographic, clinical, and survival data and to identify factors associated with mortality in critically ill advanced cancer patients with nonelective admissions to general ICUs., Materials and Methods: Critically ill adult (≥18 years old) cancer patients nonelectively admitted to the intensive care units at the American University of Beirut Medical Center between August 1 st 2015 and March 1 st 2019 were included. Demographic, clinical, and laboratory data were prospectively collected from the first day of ICU admission up to 30 days after discharge. This study was strictly observational, and clinical decisions were left to the discretion of the ICU team and attending physician., Results: 272 patients were enrolled in the study between August 1 st 2015 and March 1 st 2019, with an ICU mortality rate of 43.4%, with the number rising to 59% within 30 days of ICU discharge. The mean length of stay in our ICU was 14 days (IQR: 1-120) with a median overall survival of 22 days since the date of ICU admission. The major reasons for unplanned ICU admission were sepsis/septic shock (54%) and respiratory failure (33.1%). Cox regression analysis revealed 7 major predictors of poor prognosis. Direct admission from the ED was associated with a higher risk of mortality (48.9%) than being transferred from the floor (32.6%) ( p =0.014)., Conclusion: Our study has shown that being directly admitted to the ICU from the ED rather than being transferred from regular wards, developing AKI, sepsis, MOF, and ARDS, or having an uncontrolled malignancy are all predictive factors for short-term mortality in critically ill cancer patients nonelectively admitted to the ICU. Vasopressor use and mechanical ventilation were also predictors of mortality., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Hazem I. Assi et al.)

Less morbidity is considered among the advantages of laparoscopic liver resection (LLR) for HCC patients. However, our previous international, multi-institutional, propensity score-based study of emerging laparoscopic repeat liver resection (LRLR) failed to prove this advantage. We hypothesize that these results may be since the study included complex LRLR cases performed during the procedure's developing stage. To examine it, subgroup analysis based on propensity score were performed, defining the proximity of the tumors to major vessels as the indicator of complex cases. Among 1582 LRLR cases from 42 international high-volume liver surgery centers, 620 cases without the proximity to major vessels (more than 1 cm far from both first-second branches of Glissonian pedicles and major hepatic veins) were selected for this subgroup analysis. A propensity score matching (PSM) analysis was performed based on their patient characteristics, preoperative liver function, tumor characteristics and surgical procedures. One hundred and fifteen of each patient groups of LRLR and open repeat liver resection (ORLR) were earned, and the outcomes were compared. Backgrounds were well-balanced between LRLR and ORLR groups after matching. With comparable operation time and long-term outcome, less blood loss (283.3±823.0 vs. 603.5±664.9 mL, p = 0.001) and less morbidity (8.7 vs. 18.3 %, p = 0.034) were shown in LRLR group than ORLR. Even in its worldwide developing stage, LRLR for HCC patients could be beneficial in blood loss and morbidity for the patients with less complexity in surgery.

Non-covalent functionalisation of the carbon nanotube (CNT) sidewall through polymer wrapping is the key strategy for improving well-dispersed CNTs without persistent alteration of their electronic properties. In this work, the effect of reaction time on regioregular poly (3-hexylthiophene-2,5-diyl) (P3HT)-wrapped hydroxylated multi-walled CNT (MWCNT-OH) nanocomposites was investigated. Five different reaction times (24, 48, 72, 96, and 120 h) were conducted at room temperature in order to clearly determine the factors that influenced the quality of wrapped MWCNT-OH. Morphological analysis using Field Emission Scanning Electron Microscopic (FESEM) and High-Resolution Transmission Electron Microscope (HRTEM) analysis showed that P3HT successfully wrapped the MWCNT-OH sidewall, evidenced by the changes in the mean diameter size of the nanocomposites. Results obtained from Raman spectroscopy, X-ray Photoelectron Spectroscopy (XPS) as well as Thermogravimetric Analysis (TGA) showed a significant effect of the wrapped polymer on the CNT sidewall as the reaction time increased. Overall, the method used during the preparation of P3HT-wrapped MWCNT-OH and the presented results significantly provided a bottom-up approach to determine the effect of different reaction times on polymer wrapping to further expand this material for novel applications, especially chemical sensors.

Introduction: Sarcomas are uncommon malignancies. No advances have been recently achieved despite multiple efforts. Pazopanib is a safe and effective tyrosine kinase inhibitor used in managing soft tissue sarcomas (STS) after chemotherapy failure. However, its use is limited in developing countries and no efficacy data exist from our region. We aimed to study the efficacy of pazopanib in our population, characterized by response rates of patients with chemotherapy-refractory advanced STS receiving pazopanib. Secondary endpoints included progression-free survival (PFS), overall survival (OS) and toxicity profile., Materials and Methods: 15 patients (age≥18 year) diagnosed with advanced STS, refractory to first-line chemotherapy, receiving pazopanib as ≥second-line therapy in one tertiary center in Lebanon were included between January 1st, 2014 and October 31st, 2018. Patient and disease characteristics, disease evaluation, as well as tolerance to treatment, were extracted from charts retrospectively. Statistical analysis was done using SPSS version 24., Results: The mean age was 48.6 [19-66] years. Eleven patients (73.3%) received pazopanib in second-line, whereas four patients (26.7%) received it in third-line. Thirteen patients (86.7%) progressed, and two patients (13.3%) had stable disease. The median PFS was three months [1-19] and the mean OS was 25.4 months [17.2-33.6]. Five patients required dose-reductions due to poor tolerance., Conclusion: Conclusions cannot be drawn due to small patient numbers. However, given the 3-month PFS, 13% of patients maintaining stable disease, and tolerable safety profile, it is reasonable to incorporate pazopanib in STS treatment. More focused studies with larger patient populations need to be done in Lebanon., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Carbon nanotubes (CNTs) have been recognised as a promising material in a wide range of applications, from safety to energy-related devices. However, poor solubility in aqueous and organic solvents has hindered the utilisation and applications of carbon nanotubes. As studies progressed, the methodology for CNTs dispersion was established. The current state of research in CNTs either single wall or multiwall/polymer nanocomposites has been reviewed in context with the various types of functionalisation presently employed. Functionalised CNTs have been playing an increasingly central role in the research, development, and application of carbon nanotube-based nanomaterials and systems. The extremely high surface-to-volume ratio, geometry, and hollow structure of nanomaterials are ideal for the adsorption of gas molecules. This offers great potential applications, such as in gas sensor devices working at room temperature. Particularly, the advent of CNTs has fuelled the invention of CNT-based gas sensors which are very sensitive to the surrounding environment. The presence of O 2 , NH 3 , NO 2 gases and many other chemicals and molecules can either donate or accept electrons, resulting in an alteration of the overall conductivity. Such properties make CNTs ideal for nano-scale gas-sensing materials. Conductive-based devices have already been demonstrated as gas sensors. However, CNTs still have certain limitations for gas sensor application, such as a long recovery time, limited gas detection, and weakness to humidity and other gases. Therefore, the nanocomposites of interest consisting of polymer and CNTs have received a great deal of attention for gas-sensing application due to higher sensitivity over a wide range of gas concentrations at room temperature compared to only using CNTs and the polymer of interest separately., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Phenolic acids of oak gall were extracted using ultrasonic-probe assisted extraction (UPAE) method in the presence of ionic liquid. It was compared with classical ultrasonic-bath assisted extraction (CUBAE) and conventional aqueous extraction (CAE) method, with and without the presence of ionic liquid. Remarkably, the UPAE method yielded two-fold higher extraction yield with the presence of ionic liquid, resulting 481.04 mg/g for gallic acids (GA) and 2287.90 mg/g for tannic acids (TA), while a decreased value of 130.36 mg/g for GA and 1556.26 mg/g for TA were resulted with the absence of ionic liquid. Intensification process resulted the highest yield of 497.34 mg/g and 2430.48 mg/g for GA and TA, respectively, extracted at temperature 50 °C with sonication intensity of 8.66 W/cm 2 and 10% duty cycle, diluted in ionic liquid, 1-Butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide, [Bmim][Tf 2 N] at concentration of 0.10 M with sample-to-solvent ratio 1:10 for 8 h. Peleg's model successfully predicted the UPAE process confirming that extraction capacity is the controlling factor in extracting phenolic acids. Hence, it can be concluded that UPAE method and ionic liquid have synergistic effect as it effectively enhanced the extraction efficiency to increase the bioactive constituents yield., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Organophosphorus (OP) compounds are highly toxic synthetic compounds which have been used as pesticides and developed as warfare nerve agents. They represent a threat to both military and civilian populations. OP pesticides affect the nervous system and are thought to have caused at least 5 million deaths since their discovery in the 1930s. At present the treatment of OP nerve agent poisoning commonly involves the use of parenteral oximes. However, the blood brain barrier (BBB) remains a challenge in the delivery of oximes to the central nervous system (CNS). This is because almost all macromolecule drugs (including oximes) fail to pass through the BBB to reach the CNS structures. The presence of a permanent cationic charge in oximes has made these compounds inefficient in crossing the BBB. Thus, oximes are unable to reactivate acetylcholinesterase (AChE) in the CNS. Using current structural and mechanistic understanding of the BBB under both physiological and pathological conditions, it becomes possible to design delivery systems for oximes and other drugs that are able to cross the BBB effectively. This review summarises the recent strategies in the development of oximes which are capable of crossing the BBB to treat OP poisoning. Several new developments using oximes are reviewed along with their advantages and disadvantages. This review could be beneficial for future directions in the development of oxime and other drug delivery systems into the CNS., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Aim: This study assessed the efficacy of anti-PD-1/PD-L1 agents in real life when used in second line or beyond. Materials & methods: Patients with advanced non-small-cell lung cancer progressing after standard chemotherapy and receiving immunotherapy in the second line or beyond were included. Results: One hundred and ten patients were included with PD-L1 expression above 50%, between 1-49 and <1% in 38.6, 27.3 and 34.1% of patients, respectively. Checkpoint inhibitors were used as second, third and fourth line in 74.7, 21.8 and 3.5%, respectively. Partial response was observed in 25.6% of patients. Median progression-free survival was 4 months and median overall survival was 8.1 months. Conclusion: Immunotherapies are emerging as important tools in the oncologic field with good responses in real-life practice.

Purpose. In this study, we aim to describe and compare the demographical, clinical and laboratory features of leptospirosis and dengue co-infections (LDCI) against single leptospirosis infections in Malaysia. Methodology. Data of patients admitted to various hospitals in Malaysia from 2011 to 2015 diagnosed with leptospirosis in our laboratory were obtained from their admission records. Co-infection with dengue was determined by collecting dengue serology results. Multivariate analysis and multiple logistic regression were used to differentiate features between single leptospirosis infection and confirmed LDCI. Results/Key findings. Only 602 (29.11 %) out of 2068 leptospira-positive patients were concurrently tested for dengue during their admission in which 44 (7.31 %) patients had positive non-structural protein 1 (confirmed LDCI) while 140 (23.26 %) were positive for dengue IgM (probable LDCI) with the highest number of cases recorded in high-density suburban districts. Myalgia and arthralgia were the only significant distinguishing clinical feature of LDCI while significant laboratory features were thrombocytopenia and high levels of alanine and aspartate transaminases. Only thrombocytopenia displayed a predictive value for LDCI from analysis of multiple logistic regression. Death occurred in 19 (3.16 %) patients in this dataset studied but only three (0.50 %) were attributed to LDCI. Conclusion. There is a considerable prevalence of LDCI in this country of which overlapping demographic, clinical and laboratory presentations pose diagnostic and therapeutic challenges. Efforts to raise awareness regarding LDCI, better access to diagnostic services and further prospective studies are warranted.

Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Epidemiological study on strongyloidiasis in humans is currently lacking in Malaysia. Thus, a cross-sectional study was carried out to determine the prevalence of Strongyloides stercoralis infection among the inhabitants of longhouse indigenous communities in Sarawak. A single stool and blood sample were collected from each participant and subjected to microscopy, serological and molecular techniques. Five species of intestinal parasites were identified by stool microscopy. None of the stool samples were positive for S. stercoralis . However, 11% of 236 serum samples were seropositive for strongyloidiasis. Further confirmation using molecular technique on stool samples of the seropositive individuals successfully amplified 5 samples, suggesting current active infections. The prevalence was significantly higher in adult males and tended to increase with age. S. stercoralis should no longer be neglected in any intestinal parasitic survey. Combination of more than 1 diagnostic technique is necessary to increase the likelihood of estimating the 'true' prevalence of S. stercoralis .

Leptospira interrogans serovar Bataviae was recently identified as one of the persistent Leptospira serovars in Malaysia. Here, we report the draft genome sequence of the L. interrogans serovar Bataviae strain LepIMR 22 isolated from kidney of a rodent in Johor, Malaysia., (Copyright © 2016 Amran et al.)

Background: Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated., Methods: A randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration., Results: There was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P = 0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group., Conclusions: There was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED.

Dengue is the most important mosquito-borne viral disease. No specific treatment or vaccine is currently available; traditional vector control methods can rarely achieve adequate control. Recently, the RIDL (Release of Insect carrying Dominant Lethality) approach has been developed, based on the sterile insect technique, in which genetically engineered 'sterile' homozygous RIDL male insects are released to mate wild females; the offspring inherit a copy of the RIDL construct and die. A RIDL strain of the dengue mosquito, Aedes aegypti, OX513A, expresses a fluorescent marker gene for identification (DsRed2) and a protein (tTAV) that causes the offspring to die. We examined whether these proteins could adversely affect predators that may feed on the insect. Aedes aegypti is a peri-domestic mosquito that typically breeds in small, rain-water-filled containers and has no specific predators. Toxorhynchites larvae feed on small aquatic organisms and are easily reared in the laboratory where they can be fed exclusively on mosquito larvae. To evaluate the effect of a predator feeding on a diet of RIDL insects, OX513A Ae. aegypti larvae were fed to two different species of Toxorhynchites (Tx. splendens and Tx. amboinensis) and effects on life table parameters of all life stages were compared to being fed on wild type larvae. No significant negative effect was observed on any life table parameter studied; this outcome and the benign nature of the expressed proteins (tTAV and DsRed2) indicate that Ae. aegypti OX513A RIDL strain is unlikely to have any adverse effects on predators in the environment.

Chlamydia trachomatis infection is considered to be one of the most common sexually transmitted diseases. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands has consequences for male infertility. To determine the frequency of C. trachomatis Infection among infertile men with leukocytospermia using different diagnostic techniques such as the detection of secretory IgA antibodies (Abs) in seminal plasma by enzyme-linked immunosorbent assay (ELISA), plasmid DNA by polymerase chain reaction (PCR) and direct detection of elementary body by flowcytometric analysis in seminal fluid. To assess the relationship between C. trachomatis infection and semen quality hence male infertility. Seventy five infertile male patients with leukocytospermia and 25 apparently healthy age matched fertile men were included as controls. Routine semen analysis and LeucoScreen test were done for each patient and control. Detection of C. trachomatis secretory IgA in seminal plasma by ELISA and detection of plasmid DNA by PCR and elementary body by flowcytometric analysis in semen samples were performed. Primary and secondary infertility were detected in 55 (73.3%) and 20 (26.7%) of patients, respectively. Sperm concentration and sperm motility (A+B) were statistically significant lower in patients with leucocytospermia than control group (P < 0.0001). Sperm concentration in patients with pus cells more than 3 x 10(6)/ml was statistically significant lower than those with pus cells less than 2 x 10(6) /ml. ELISA-detected IgA Abs against C. trachomatis in patients seminal plasma were positive in 20 (26.7%) and equivocal in 5 (6.6%) patients. Flowcytometric analysis of semen sample for C. trachomatis was positive in 35 (46.6%) patients and C. trachomatis plasmid DNA detection by PCR was positive in 23 (30.7%) patients. In conclusions, Detection of C. trachomatis antibodies of IgA type by ELISA in seminal plasma appears to be as specific as PCR in diagnosis of C. trachomatis in seminal fluid. High detection rate of C. trachomatis by flowcytometry was observed. Concerning the effect of C. trachomatis on routine semen characteristics, no significant obvious changes could be detected. Further studies for the assessment of sperm viability and DNA integrity are recommended.