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This paper reports on a frontier study undertaken to examine the influence of mortality rates due to diabetes (DBT) and medical services expenditure (EXP) on economic growth (RGDPP) in Malaysia. The results of the Johansen test for cointegration allowed the acceptance of r = 2 as our estimate of the number of cointegrating equations among the three of variables. The negative sign of the residual in the estimated Error Correction Modelling (ECM) indicated the existence of a long-run equilibrium relationship among RGDPP, EXP and DBT, while the coefficient for error term implied that the system corrected its previous period disequilibrium due to positive or negative shocks in one period at an adjustment speed of 9.23 percent annually. These findings have substantive implications on the efforts to promote and achieve satisfactory health and wellness in Malaysia, and highlight a critical need for an effective long-term national strategy to resolve diabetes related economic issues. The results provide a useful foundation for a much needed national debate to review health-care spending in relation to choosing the best methods in reducing and alleviating diabetes and other chronic diseases such as cancer and cardiovascular disease. Additional priority areas that merit further study are highlighted to help in measuring and addressing the economic, human, and social costs of preventable chronic diseases and to identify opportunities to ameliorate these important aspects within the economy.

Aims: To apply scanning electron microscopy, image analysis and a fluorescent viability stain to assess lethal and sublethal injury in food‐borne bacteria exposed to pulsed‐plasma gas discharges (PPGD). Methods and Results: The fluorescent redox probe 5‐cyano‐2,3‐ditolyl tetrazolium chloride (CTC) was used for enumerating actively respiring cells of Campylobacter jejuni, Escherichia coli, Listeria monocytogenes, Staphylococcus aureus and Salmonella enterica serovar Typhimurium that were suspended in sterile water at 4°C and exposed to separate PPGD and heat treatments. While there was good agreement between use of respiratory staining (RS) and direct‐selective agar plate counting (PC) for enumerating untreated bacteria, there were c. 1 and 3 log‐unit differences in surviving cell numbers per millilitre for test organisms subjected to PPGD and heat treatments respectively, when enumerated by these different viability indicators. PPGD‐treated bacteria were markedly altered at the cellular level when examined by scanning electron microscopy. Conclusions: Use of this RS method revealed that substantial subpopulations of test bacteria rendered incapable of forming colonies by separate PPGD and heat treatments may remain metabolically active. yes

Aims: To apply scanning electron microscopy, image analysis and a fluorescent viability stain to assess lethal and sublethal in food-borne bacteria exposed to high-intensity pulsed electric fields (PEF). Methods and Results: A rapid cellular staining method using the fluorescent redox probes 5-cyano-2,3-ditolyl tetrazolium chloride (CTC) and 4¢,6-diamidino-2-phylindole was used for enumerating actively respiring cells of Listeria mononcytogenes, Bacillus cereus and Escherichia coli. This respiratory staining (RS) approach provided good agreement with the conventional plate count agar method for enumerating untreated and high-intensity PEFtreated bacteria suspended in 0.1% (w/v) peptone water. However, test organisms subjected to similar levels of lethality by heating at 56 C resulted in ca 3-log-unit difference in surviving cell numbers ml)1 when enumerated by these different viability indicators. PEF-treated bacteria were markedly altered at the cellular level when examined by scanning electron microscopy. Conclusions: While PEF-treatment did not produce sublethally injured cells (P < 0.05), substantial subpopulations of test bacteria rendered incapable of forming colonies by heating may remain metabolically active. Significance and Impact of the Study: The fluorescent staining method offers interesting perspectives on assessing established and novel microbial inactivation methods. Use of this approach may also provide a better understanding of the mechanisms involved in microbial inactivation induced by PEF. yes

The physical effects of high‐intensity pulsed electric fields (PEF) on the inactivation of diarrhoeagenic Bacillus cereus cells suspended in 0·1% peptone water were examined by transmission electron microscopy (TEM). The levels of PEF‐induced microbial cell death were determined by enumeration on tryptone soy yeast extract agar and Bacillus cereus‐selective agar plates. Following exposure to lethal levels of PEF, TEM investigation revealed irreversible cell membrane rupture at a number of locations, with the apparent leakage of intracellular contents. This study provides a clearer understanding of the mechanism of PEF‐induced cellular damage, information that is essential for the further optimization of this emerging food‐processing technology. yes

Transmission electron microscopy (TEM) studies revealed that rough cell-forms of L. monocytogenes (designated FR variants), isolated from clinical and food samples (and under conditions of sublethal heat stress), consist of either single or paired long-®laments. These FR variants markedly contrast in cell morphology from other previously described avirulent rough-mutants of L. monocytogenes that form long chains consisting of multiple cells of similar size (designated MCR variants). The identity of these Listeria isolates was determined using a commercially available, anti- Listeria polyclonal KPL antibody and by the API Listeria biochemical gallery. This study shows that ®lamentous rough-forms of L. monocytogenes may occur in clinical and food samples that are of undetermined pathogenicity. yes

The effects of high intensity light emissions, produced by a novel pulsed power energization technique (PPET), on the survival of bacterial populations of verocytotoxigenic Escherichia coli (serotype 0157:H7) and Listeria monocytogenes (serotype 4b) were investigated. Using this PPET approach, many megawatts (MW) of peak electrical power were dissipated in the light source in an extremely short energization time (about 1 μs). The light source was subjected to electric field levels greater than could be achieved under conventional continuous operation, which led to a greater production of the shorter bacteriocidal wavelengths of light. In the exposure experiments, pre‐determined bacterial populations were spread onto the surface of Trypone Soya Yeast Extract Agar and were then treated to a series of light pulses (spectral range of 200–530 nm) with an exposure time ranging from 1 to 512 μs. While results showed that as few as 64 light pulses of 1 μs duration were required to reduce E. coli 0157:H7 populations by 99·9% and Listeria populations by 99%, the greater the number of light pulses the larger the reduction in cell numbers (P < 0·01). Cell populations of E. coli 0157:H7 and Listeria were reduced by as much as 6 and 7 log10 orders at the upper exposure level of 512 μs, respectively. Survival data revealed that E. coli 0157:H7 was less resistant to the lethal effects of radiation (P < 0·01). These studies have shown that pulsed light emissions can significantly reduce populations of E. coli 0157:H7 and L. monocytogenes on exposed surfaces with exposure times which are 4–6 orders of magnitude lower than those required using continuous u.v. light sources. yes

One hundred reconstituted milk-based infant formulae (IMF) representative of 10 leading brands available in many European Economic Community countries were examined for Bacillus cereus and for the presence of diarrheal enterotoxin. Sixty-three reconstituted IMF supported growth of the organism after 14 h at 25&C, and in 4 of these, which contained maltodextrin, enterotoxin was detected. Reconstituted IMF (and basal synthetic media) supplemented with >0.1% maltodextrin supported both growth of B. cereus and diarrheal toxin production when incubated for 14 h or more at 25&C. yes