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Response surface methodology with central composite design was used to investigate the influence of pulping conditions, viz. cooking temperature, time-at-temperature and alkali charge for alkaline pulping of oil palm empty fruit bunch fibres, on the properties of the pulp and paper obtained (screened yield, Kappa number, tensile and tear indices). Quadratic models consisting of the three independent variables were found to accurately describe the pulping of this material with correlation between the actual and predicted values of the response variables having a relatively good degree of R 2. The delignification of oil palm empty fruit bunch fibre can be achieved with ease using sodium hydroxide as the sole cooking agent to about 30?45% yield with the process greatly enhanced by an increase in temperature. Although, a relatively low temperature (about 160°C) within the limits of pulping time (60?120 min) and of alkali charge between 20 and 30% is generally sufficient. [ABSTRACT FROM AUTHOR]

The main purpose of this present study is to evaluate the ability of near infrared technology as an alternative method in determining and assessing quality parameters of meat product where in this case is frozen beef. At first, beef samples from chest and legs parts were sliced and taken at the amount of 100g per sample to be frozen. Then spectra data of beef samples were obtained using near infrared spectrophotometer (PSD IR i16) in wavelength range from 1000 to 2500 nm with optical gain 4x. Actual protein contents were obtained by Kjeldahl method and measured in triplicate. The near infrared spectra data were enhanced and improved by means of mean centering (MC) and baseline shift correction (BSC) methods. The results showed that protein content of frozen beef samples can be predicted rapidly with maximum correlation coefficient is 0.91. Heat properties of beef samples changes exponentially during freezing and thus, optimum freezing temperature and time can be predicted as well. Based on those obtained results, it may conclude that near infrared technology can assess frozen beef qualities rapidly and effectively.

An adult female Sumatran rhinoceros was observed with a swelling in the left infraorbital region in March 2017. The swelling rapidly grew into a mass. A radiograph revealed a cystic radiolucent area in the left maxilla. In June 2017, the rhinoceros was euthanized. At necropsy, the infraorbital mass measured 21 cm × 30 cm. Samples of the infraorbital mass, left parotid gland, and left masseter muscle were collected for histopathology (Hematoxylin & Eosin, Von Kossa, Masson’s trichrome, cytokeratin AE1/AE3, EMA, p53, and S-100). Numerous neoplastic epithelial cells showing pleomorphism and infiltration were observed. Islands of dentinoid material containing ghost cells and keratin pearls were observed with the aid of the two special histochemistry stains. Mitotic figures were rarely observed. All the neoplastic odontogenic cells and keratin pearls showed an intense positive stain for cytokeratin AE1/AE3, while some keratin pearls showed mild positive stains for S-100. All samples were negative for p53 and S-100 immunodetection. The mass was diagnosed as a dentinogenic ghost cell tumor.

Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed.

Obesity is a major health concern associated to diabetes, cardiovascular disease, and cancer. Brown adipocytes, which specialise in thermogenesis, offer a potential therapeutic target for obesity prevention and related conditions. This study builds on previous findings of the browning activity of Averrhoa bilimbi hexane fractions and aims to elucidate the underlying mechanisms in vitro. Squalene and phytol, key phytocompounds from bilimbi leaf extract and fractions, were assessed for their ability to induce thermogenic adipocyte using 3T3-L1 preadipocytes and C2C12 myoblasts in vitro models. The result shows that bilimbi fractions F7, F8, and F9, along with squalene and phytol, effectively induced thermogenic adipocyte differentiation. This was evidenced by the upregulation of key markers, including Ucp1 , Prdm16 , and Pgc1α , and increased expression of the brown adipocyte-specific protein CIDEA in treated 3T3-L1 preadipocytes. Notably, all treatments promoted thermogenic adipocytes differentiation in C2C12 myoblasts via the upregulation of Pgc1α, Ucp1 genes, and UCP1 protein. These findings suggest that bilimbi fractions and its phytocompounds may hold potential as nutraceutical interventions for obesity management., 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.)

The potential alternative of exploring the development of nanocomposites through a single-molecule approach, such as combining chitosan nanoparticles (ChiNP) with chitosan (Chi), remains to be investigated. To maintain the insolubility of the ChiNP filler in the system, the protonation of weakly basic amino groups necessitates the pH of the coating solution above the pKa (6-6.5). This study aimed to evaluate the biofunctional properties improvements of Chi coatings incorporated with ChiNP as filler agents. The coating film forming solution comprised of 0.8 % Chi combined with varying concentrations (0 %, 0.1 %, 0.5 %, and 1 %) of ChiNP. The morphology of ChiNP was characterized via atomic force spectroscopy (AFM). Incorporating the ChiNP (1 %) significantly enhanced antifungal efficacy, i.e., an 88.28 % reduction in fungal activity compared with the control group, and a 65 % reduction compared with pure Chi against Botrytis cinerea. The incorporation of ChiNP improved the ultraviolet and visible light wavelengths, water vapor permeability, hydrophobicity, and thermal properties. Scanning electron microscopy and AFM were performed to assess the surface and internal microstructures of the coating. The findings of this study suggested that the nanocomposite coatings herein presented is potential for use in active packaging, especially in the context of preserving fresh fruit products., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The increasing interest in exploring beliefs about teaching mathematics with technology has led educators to employ belief systems as a framework for understanding the impact of technology on math instruction. However, the complex nature of pre-service teachers' beliefs in teaching mathematics with technology involves various dimensions. This study aims to investigate the predictive relationship between Technological Pedagogical Content Knowledge (TPACK) sub-components and beliefs in teaching mathematics with technology, revealing a statistically significant direct impact. Utilizing a correlational research approach, we collected data from a cohort of 159 Malaysian pre-service teachers with a focus on mathematics education. Structural Equation Modelling (SEM) was employed to analyze the proposed model. The measurement model exhibited a satisfactory fit with the collected data. Notably, technological knowledge (25 %), technological pedagogical content knowledge (69 %), and technological content knowledge (39 %) significantly influence discovery learning, while technological knowledge (24 %), technological pedagogical content knowledge (74 %), and technological content knowledge (30 %) significantly influence multiple representations. This underscores the critical role of TPACK in shaping educators' perspectives and practices, providing a crucial avenue for enhancing technology integration in teaching mathematics., Competing Interests: Declaration of competing interest The authors have stated that there are no conflicts of interest regarding the subject matter of this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Double outlet of both ventricles is an anomaly wherein both ventricles equally share the arterial trunks. A majority of the literature describes a variant of this disease with a muscular outlet septum which is perpendicular to the plane of the ventricular septum although a variant with a fibrous muscular septum can also be present. The condition may be associated with obstruction of either outflow tract, which may complicate repair. We report a child with double outlet of both ventricles and a fibrous outlet septum with unobstructed outflows. The child underwent a successful surgical repair using a two-patch technique., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Mechanical prosthetic valve dysfunction can be structural or non-structural. Structural valve dysfunction includes disc dislodgement, disc fracture, and strut fracture. These events in an implanted valve are rare but could pose a risk to life. TTK Chitra heart valve prosthesis (CHVP), an Indian-made single tilting disc valve, has been implanted since 1990 as reported by Vayalappil and Bhuvaneswar (2005). There is limited literature on the structural valve dysfunction of CHVP. We hereby submit images of the dysfunctional valve from our patient, a case of acute severe mitral paravalvular regurgitation 16 years after implantation of CHVP., Competing Interests: Conflict of interestThe authors declare that there is no conflict of interest., (© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Agrobacterium-mediated transformation and particle bombardment are the two common approaches for genome editing in plant species using CRISPR/Cas9 system. Both methods require careful manipulations of undifferentiated cells and tissue culture to regenerate the potentially edited plants. However, tissue culture techniques are laborious and time-consuming., Methods and Results: In this study, we have developed a simplified, tissue culture-independent protocol to deliver the CRISPR/Cas9 system through in planta transformation in Malaysian rice (Oryza sativa L. subsp. indica cv. MR 219). Sprouting seeds with cut coleoptile were used as the target for the infiltration by Agrobacterium tumefaciens and we achieved 9% transformation efficiency. In brief, the dehusked seeds were surface-sterilised and imbibed, and the coleoptile was cut to expose the apical meristem. Subsequently, the cut coleoptile was inoculated with A. tumefaciens strain EHA105 harbouring CRISPR/Cas9 expression vector. The co-cultivation was conducted for five to six days in a dark room (25 ± 2 °C) followed by rooting, acclimatisation, and growing phases. Two-month-old plant leaves were then subjected to a hygromycin selection, and hygromycin-resistant plants were identified as putative transformants. Further validation through the polymerase chain reaction verified the integration of the Cas9 gene in four putative T 0 lines. During the fruiting stage, it was confirmed that the Cas9 gene was still present in three randomly selected tillers from two 4-month-old transformed plants., Conclusion: This protocol provides a rapid method for editing the rice genome, bypassing the need for tissue culture. This article is the first to report the delivery of the CRISPR/Cas9 system for in planta transformation in rice., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background and Purpose: and purpose: Non-alcoholic fatty liver disease (NAFLD) is a significant global health concern with limited pharmacotherapy options. This study aimed to evaluate the effectiveness of a standardized extract of Phyllanthus niruri in mild-to-moderate NAFLD., Materials and Methods: This was a 12-month randomized controlled trial, in which adults with a controlled attenuation parameter (CAP) score >250 dB/m and a fibrosis score <10 kPa were randomly assigned to receive a standardized P. niruri extract at a dose of 3,000 mg daily (n = 112) or a placebo (n = 114). The primary outcomes were changes in CAP score and liver enzyme levels, while the secondary outcomes were changes in other metabolic parameters. The analysis was performed on an intention-to-treat basis., Results: After 12 months, there was no significant difference in the change of CAP score between the intervention and control groups (-15.05 ± 36.76 dB/m vs. -14.74 ± 41.08 dB/m; p = 0.869). There was also no significant difference in the changes of liver enzyme levels between the two groups. However, the intervention group showed a significant reduction in fibrosis score, which was not observed in the control group (-0.64 ± 1.66 kPa versus 0.10 ± 1.61 kPa; p = 0.001). No major adverse events were reported in either group., Conclusion: This study showed that P. niruri did not significantly reduce CAP score and liver enzyme levels in patients with mild-to-moderate NAFLD. However, a significant improvement in fibrosis score was observed. Further research is needed to determine its clinical benefits at different dosages for NAFLD treatment., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Huan-Keat Chan reports equipment, drugs, or supplies was provided by Nova Laboratories Ltd., (© 2023 The Authors.)

Drought stress significantly reduces grain yield (GY) due to poor spikelet fertility and anthesis quality. Aim of this study was to understand the changes of flowering capacity, anthesis quality traits and seed set in the re-watered drought stressed modern high yielding drought susceptible rice cultivar, IR64 at heading (DSH) and booting (DSB) stages. The well-watered plants served as control of the experiment. Results obtained suggest that spikelet moisture content at above 80% was required to maintain optimum anthesis process in rice. Anthesis process in DSH plant was suspended when leaf relative water content (LRWC) dropped to below than 70%. Effects of drought stress on the spikelet moisture were irreversible as compared to the leaf rolling and LRWC. Hence, seed set was failed to occur at the upper rachis branches of the DSH plant. Anthesis process in the re-watered drought stress plants was resumed on the third day after re-watering with about 50% and 80% of anthers managed to dehisce in the DSH and DSB plants. Consequently, percentage of spikelet fertility and seed set in the DSH and DSB plants were increased towards the lower parts of the panicle. The GY, number of seeds, spikelet fertility, and harvest index however were significantly lower in the DSH plant (0.30 g, 13, 16.40% and 14.81) as compared to DSB plant (1.34 g, 57, 59.14% and 48.30), respectively. In addition, all interrelated traits involved in the flowering process of rice could be collectively termed as the anthesis quality traits due to their significant correlation with the grain yield and other yield components., (© Penerbit Universiti Sains Malaysia, 2022.)

Introduction: Diabetic Peripheral Neuropathy (DPN), the most common complication of Diabetes Mellitus (DM), is often under-diagnosed and inadequately treated. This study identified the proportion of undiagnosed DPN and its associated risk factors among patients with established type 2 DM (T2DM) in community health clinics in the Gombak district., Methods: A cross-sectional study was conducted in 2 community health clinics within the Gombak district between September and December 2017. Adults with T2DM were selected via systematic random sampling and screened using the Neuropathy Symptoms Score (NSS). Clinical records of participants' foot examinations were reviewed to identify positive findings of DPN and compared with the NSS., Results: The study's sample comprised 425 patients. Most had co-morbidities, including hypertension, dyslipidaemia and pre-existing DM-related complications. About two-thirds of them performed no daily foot inspection and had no proper footwear. The proportion of patients with positive NSS was 49.4%. However, only 0.2% were diagnosed with positive DPN in their clinical foot examination record., Conclusion: Although a positive NSS was identified in 1 out of 2 patients with established DM, only 0.2% of patients had DPN on their examination records. Most patients had never done daily foot inspections and lacked proper footwear. A positive NSS was associated with uncontrolled diabetes and lower BMI. Proper screening and examination for patients, especially those with uncontrolled diabetes and low BMI, is crucial in identifying DPN to ensure that these diabetic patients receive better preventative care, especially proper foot care and strict diabetic control, to prevent DPN-related complications., (© Academy of Family Physicians of Malaysia.)

In this study, a cellulose membrane (CM) was chemically treated with phenolic (PF) resin to improve its performance as a polymeric insulator. The CM was prepared from kenaf pulp, and the PF was synthesized from oil palm empty fruit (EFB) fibre. Four different concentrations of synthesized PF resin (5, 10, 15, and 20 wt.%) were impregnated under wet or dry conditions. Thermal analysis of the phenolic cellulose membrane (PCM) showed that the samples had good chemical interaction and compatibility. The PF uptake in the wet phenolic cellulose membrane (PCMW) was higher than in the dry phenolic cellulose membrane (PCMD). During the PF uptake, the CM underwent solvent exchange and absorption in wet and dry membranes, respectively. This difference also affected the crosslinking of PCM samples via the formation of methylene bridges. Due to the PF treatment, the PCM showed lower water absorption than CM. The PF concentrations also affect the surface roughness and electrical properties of PCM samples. These findings prove that PCM can be used as a renewable and green polymer electrical insulator.

Introduction: To achieve the elimination of hepatitis C virus (HCV), substantial scale-up in access to testing and treatment is needed. This will require innovation and simplification of the care pathway, through decentralisation of testing and treatment to primary care settings and task-shifting to non-specialists. The objective of this study was to evaluate the feasibility and effectiveness of decentralisation of HCV testing and treatment using rapid diagnostic tests (RDTs) in primary healthcare clinics (PHCs) among high-risk populations, with referral of seropositive patients for confirmatory viral load testing and treatment., Methods: This observational study was conducted between December 2018 and October 2019 at 25 PHCs in three regions in Malaysia. Each PHC was linked to one or more hospitals, for referral of seropositive participants for confirmatory testing and pretreatment evaluation. Treatment was provided in PHCs for non-cirrhotic patients and at hospitals for cirrhotic patients., Results: During the study period, a total of 15 366 adults were screened at the 25 PHCs, using RDTs for HCV antibodies. Of the 2020 (13.2%) HCV antibody-positive participants, 1481/2020 (73.3%) had a confirmatory viral load test, 1241/1481 (83.8%) were HCV RNA-positive, 991/1241 (79.9%) completed pretreatment assessment, 632/991 (63.8%) initiated treatment, 518/632 (82.0%) completed treatment, 352/518 (68.0%) were eligible for a sustained virological response (SVR) cure assessment, 209/352 (59.4%) had an SVR cure assessment, and SVR was achieved in 202/209 (96.7%) patients. A significantly higher proportion of patients referred to PHCs initiated treatment compared with those who had treatment initiated at hospitals (71.0% vs 48.8%, p<0.001)., Conclusions: This study demonstrated the effectiveness and feasibility of a simplified decentralised HCV testing and treatment model in primary healthcare settings, targeting high-risk groups in Malaysia. There were good outcomes across most steps of the cascade of care when treatment was provided at PHCs compared with hospitals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The general process of learning in educational institutions around the globe has changed since the advent of the COVID-19 virus. Educational sectors in all nations are forced to adapt and rearrange their compositions and systems as the virus spreads. The current study considers the characteristics and issues related to universities moving towards online and blended learning during this period of universal isolation. Through focus group interviews conducted in South Korea and Malaysia, the study provides recommendation for the improvement of online classes and blended learning. The use of student focus groups gives the research an alternative perspective with which to assess the satisfaction level, success, and quality of online learning programs during the COVID-19 pandemic. Results from the focus groups show that for the success of online learning to become a reality, blended education should be considered to bolster learning. Further, results show that communication between lecturers and students remains a fundamental factor for success, regardless of the class category incorporated. Consequently, the results of the study provide further insight into matters experienced by students during the pandemic, and how educators may heed the opinions of students when improving future related blended learning programs., (© 2021 Elsevier Ltd. All rights reserved.)

Background: Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education., Objective: The aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting., Methods: A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods., Results: The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t 119 =41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F 2,117 =1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F 2,117 =83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches., Conclusions: Digital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education., (©Hussein Haruna, Kingsley Okoye, Zamzami Zainuddin, Xiao Hu, Samuel Chu, Samira Hosseini. Originally published in JMIR Serious Games (https://games.jmir.org), 12.10.2021.)

β-wollastonite (βW) has sparked much interest in bone defect recovery and regeneration. Biomaterial-associated infections and reactions between implants with human cells have become a standard clinical concern. In this study, a green synthesized βW, synthesized from rice husk ash and a calcined limestone precursor, was incorporated with mullite, maghemite, and silver to produce β wollastonite composite (βWMAF) to enhance the tensile strength and antibacterial properties. The addition of mullite to the βWMAF increased the tensile strength compared to βW. In vitro bioactivity, antibacterial efficacy, and physicochemical properties of the β-wollastonite and βWMAF were characterized. βW and βWMAF samples formed apatite spherules when immersed in simulated body fluid (SBF) for 1 day. In conclusion, βWMAF, according to the tensile strength, bioactivity, and antibacterial activity, was observed in this research and appropriate for the reconstruction of cancellous bone defects.

Stevia rebaudiana is a medicinal plant recommended to diabetic or obese patients as an alternative sweetener owing to its low-calorie property. Previous studies have found that the stevioside level is highest at the time of flower bud formation and lowest at the time of preceding and following flower bud formation. Hence, this study aims to identify the genes involved in the flowering of local S. rebaudiana accession MS007 by investigating the transcriptomic data of two stages of growth, before flowering (BF) and after flowering (AF) that were deposited under accession number SRX6362785 and SRX6362784 at the NCBI SRA database. The transcriptomic study managed to annotate 108299 unigenes of S. rebaudiana with 8871 and 9832 genes that were differentially expressed in BF and AF samples, respectively. These genes involved in various metabolic pathways related to flower development, response to stimulus as well as photosynthesis. Pheophorbide A oxygenase ( PAO ), eukaryotic translation initiation factor 3 subunit E ( TIF3E1 ), and jasmonate ZIM domain-containing protein 1 ( JAZ1 ) were found to be involved in the flower development. The outcome of this study will help further research in the manipulation of the flowering process, especially in the breeding programme to develop photo-insensitive Stevia plant., Competing Interests: CONFLICT OF INTEREST: none declared, (Copyright © 2021 The Author(s).)

Stevia rebaudiana ( S. rebaudiana ) is a herbaceous and perennial plant belonging to Asteraceae family. The genus stevia is well known as a natural producer of sweetener comprising non-caloric and non-carcinogenic steviol glycosides. In recent years, the capability in producing natural sweetner has increased the demand for S. rebaudiana as substitute of processed sugars. Flowering phase of S. rebaudiana has shown to affect the content of steviol glycosides in the leaves . Steviol glycosides level is the highest at the time of flower bud formation and lowest at time preceding and following flower bud formation. Therefore, sequencing and analysing the genes that are involved in flowering phase will provide platform for gene manipulation in increasing steviol glycosides content. The Stevia transcriptome data that include two stages of growth (before flowering and after flowering), were obtained using Illumina RNA-seq technology and can be accessed at NCBI Sequence Read Archive under Accession No. SRX6362785 and SRX6362784., (© 2019 The Authors.)

Consumption of curry containing poppy seeds has raised an issue concerning the opiate content in the urine that might exceed the cut-off value (300ng/mL). The main objective of this study was to examine the morphine and codeine contents in the urine of the consumers after partaking poppy seed-enriched curry in. The volunteers were asked to partake: (a) a single meal and their urines were collected within 24h, or (b) Two meals a day for three consecutive days and their urines were collected within 72h. Two different dosages were also tested in this study: (a) low dosage: 1g/100ml curry (containing 138μg of morphine and 66μg of codeine) and (b) high dosage: 5g/100ml curry (containing 690μg of morphine and 330μg of codeine). The subjects were randomised into the groups using the method of stratified randomization with age and gender groups as covariates. A total of 6 subjects was allocated for each group and placebos were used as control. Results showed that all subjects who consumed low dosage of poppy seeds either in single meal or multiple meals experiment were found negative. However, 1 out of 6high dosage subjects was confirmed positive at a period of 3-6h after the consumption of curry in the single meal study. This outlier maybe due to the lack of water consumption after consuming the curry, thus the low volume of urine was collected and the opiate was concentrated in the urine. On the other hand, 5 out of 6high dosage subjects in the multiple meals experiment were found positive. Majority of these subjects were found positive on the second and third day of the experiment after the second curry meal was consumed. The outlier (negative) in this group might be due to the high consumption of water throughout the experiment and the subject's urine volumes and frequency of urine collection were much higher compared to other subjects. From the result of this study, it can be concluded that partaking high dosages of poppy seed in curry could give a positive response (>300ng/ml+uncertainty of measurement) in the urine, and the water consumption after partaking curry has significant influence for the opiate contents in the urine., (Copyright © 2019 Elsevier B.V. All rights reserved.)

In our previous study, two known piperidine alkaloids (+)-spectaline ( 1 ) and iso-6-spectaline ( 2 ) were isolated from the leaves of Senna spectabilis and showed no toxic effect on L6 cells. In view of the potential use of piperidine alkaloids in S. spectabilis for the treatment of sleeping sickness, further investigation on the cell death actions of the parasite after treatment with compound 1 and 2 suggested that the treated parasites died by a process of autophagy based on the characteristic morphological alterations observed in intracellular T. b. rhodesiense . In search for apoptosis, interestingly, trypanosomes treated with high concentration of compound 1 and 2 after 72 h significantly induced an early apoptosis-like programmed cell death (PCD) such as phosphatidylserine (PS) exposure, loss of mitochondrial membrane potential and caspases activation. No DNA laddering discriminated late apoptosis event. Taken together, these findings demonstrated the potential of compound 1 and 2 as a natural chemotherapeutic capable of inducing a possible cross-talk between autophagy and apoptosis in T. b. rhodesiense .

Tooth agenesis in the reduction of tooth number which includes hypodontia, oligodontia and anodontia is caused by disturbances and gene mutations that occur during odontogenesis. To date, several genetic mutations that unlock the causes of non-syndromic tooth agenesis are being discovered; these have been associated with certain illnesses because tooth development involves the interaction of several genes for tooth epithelium and mesenchyme odontogenesis. Mutation of candidate genes PAX9 and MSX1 have been identified as the main causes of hypodontia and oligodontia; meanwhile, AXIN2 mutation is associated with anodontia. Previous study using animal models reported that PAX9 -deficient knockout mice exhibit missing molars due to an arrest of tooth development at the bud stage. PAX9 frameshift, missense and nonsense mutations are reported to be responsible; however, the most severe condition showed by the phenotype is caused by haploinsufficiency. This suggests that PAX9 is dosage-sensitive. Understanding the mechanism of genetic mutations will benefit clinicians and human geneticists in future alternative treatment investigations.

In our ongoing work searching for new trypanocidal lead compounds from Malaysian plants, two known piperidine alkaloids (+)-spectaline (1) and iso-6-spectaline (2) were isolated from the leaves of Senna spectabilis (sin. Cassia spectabilis). Analysis of the 1 H and 13 C NMR spectra showed that 1 and 2 presented analytical and spectroscopic data in full agreement with those published in the literature. All compounds were screened in vitro against Trypanosoma brucei rhodesiense in comparison to the standard drug pentamidine. Compound 1 and 2 inhibited growth of T. b. rhodesiense with an IC 50 value of 0.41 ± 0.01 μM and 0.71 ± 0.01 μM, without toxic effect on L6 cells with associated a selectivity index of 134.92 and 123.74, respectively. These data show that piperidine alkaloids constitute a class of natural products that feature a broad spectrum of biological activities, and are potential templates for the development of new trypanocidal drugs. To our knowledge, the compounds are being reported for the first time to have inhibitory effects on T. b. rhodesiense. The ultrastructural alterations in the trypanosome induced by 1 and 2, leading to programmed cell death were characterized using electron microscopy. These alterations include wrinkling of the trypanosome surface, formation of autophagic vacuoles, disorganization of kinetoplast, and swelling of the mitochondria. These findings evidence a possible autophagic cell death., (Copyright © 2017 Elsevier Inc. All rights reserved.)

To accelerate the discovery of novel leads for the treatment of Human African Trypanosomiasis (HAT), it is necessary to have a simple, robust and cost-effective assay to identify positive hits by high throughput whole cell screening. Most of the fluorescence assay was made in black plate however in this study the HTS assay developed in 384-well format using clear plate and black plate, for comparison. The HTS assay developed is simple, sensitive, reliable and reproducible in both types of plates. Assay robustness and reproducibility were determined under the optimized conditions in 384-well plate was well tolerated in the HTS assay, including percentage of coefficient of variation (% CV) of 4.68% and 4.74% in clear and black 384-well plate, signal-to-background ratio (S/B) of 12.75 in clear 384-well plate and 12.07 in black 384-well plate, Z' factor of 0.79 and 0.82 in clear 384-well plate and black 384-well plate, respectively and final concentration of 0.30% dimethylsulfoxide (DMSO) in both types of plate. Drug sensitivity was found to be comparable to the reported anti-trypanosomal assay in 96-well format. The reproducibility and sensitivity of this assay make it compliant to automated liquid handler use in HTS applications., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Aim: The aim of study was to evaluate the influence of ageing, lifestyle, and co morbid illnesses on treatment outcome of nocturia among men with BPH., Methods: Patients with BPH on medical therapy of least 6 months and up to 48 months were interviewed. Nocturia episodes, co morbid illnesses, beverage intake frequency, medications and work history were documented. Body Mass Index (BMI), waist circumference (WC), prostate volume, and prostate specific antigen (PSA) were recorded. Treatment failure is defined as persistent nocturia despite on medical therapy for BPH., Results: In 156 patients, the prevalence of nocturia was 96.7% while nocturia of 2 or more was 85.9%. Factors associated with treatment failure was older age (p < 0.01), usage of diuretics (p = 0.03), and antimuscarinics (p < 0.01), while active working status (p < 0.01), use of desmopression (p = 0.01), and increased coffee intake (p = 0.02) were associated with nocturia improvement. Co-morbid illnesses, obesity, WC, alcohol intake, PSA, prostate volume, and use of BPH medical therapy did not influence treatment outcome., Conclusion: Advancing age has a significance negative outcome on nocturia treatment, while standard BPH medical therapy and co morbid illnesses have an insignificant impact. However, alleviation of bothersome symptoms is possible with the understanding of its patho-physiology and individual-based approach to treatment and expected outcome.

Purpose: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases., Materials and Methods: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures., Results: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures., Conclusions: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.

We report the genome sequence of a healthcare-associated MRSA type ST239 clone isolated from a patient with septicemia in Malaysia. This clone typifies the characteristics of ST239 lineage, including resistance to multiple antibiotics and antiseptics.

Background: Electroencephalogram (EEG) signal analysis is indispensable in epilepsy diagnosis as it offers valuable insights for locating the abnormal distortions in the brain wave. However, visual interpretation of the massive amounts of EEG signals is time-consuming, and there is often inconsistent judgment between experts., Aims: This study proposes a novel and reliable seizure detection system, where the statistical features extracted from the discrete wavelet transform are used in conjunction with an improved wavelet neural network (WNN) to identify the occurrence of seizures., Method: Experimental simulations were carried out on a well-known publicly available dataset, which was kindly provided by the Epilepsy Center, University of Bonn, Germany. The normal and epileptic EEG signals were first pre-processed using the discrete wavelet transform. Subsequently, a set of statistical features was extracted to train a WNNs-based classifier., Results: The study has two key findings. First, simulation results showed that the proposed improved WNNs-based classifier gave excellent predictive ability, where an overall classification accuracy of 98.87% was obtained. Second, by using the 10th and 90th percentiles of the absolute values of the wavelet coefficients, a better set of EEG features can be identified from the data, as the outliers are removed before any further downstream analysis., Conclusion: The obtained high prediction accuracy demonstrated the feasibility of the proposed seizure detection scheme. It suggested the prospective implementation of the proposed method in developing a real time automated epileptic diagnostic system with fast and accurate response that could assist neurologists in the decision making process.

Objectives: To identify the mutations in the GJB2 gene and to determine its association with non-syndromic hearing loss in Malays., Methods: A comparative cross sectional study was conducted on a group of children from the deaf schools and the normal schools. A total of 91 buccal cell samples of non-syndromic hearing loss and 91 normal hearing children were taken. Polymerase chain reaction was used to amplify the coding region of GJB2 gene. The PCR product of GJB2 coding region was preceded with screening for mutations using denaturing high performance liquid chromatography (dHPLC) and mutations detected were confirmed by DNA sequencing., Results: Twelve sequence variations including mutations and polymorphisms were found in 32 patients and 37 control subjects. The variations were G4D, V27I, E114G, T123N, V37I and R127H in both groups, W24X, R32H, 257&#95;259 del CGC and M34L in patients only and I203T and V153I in control subjects only. There were no association between homozygous (P=0.368) or heterozygous (P=0.164) GJB2 gene and non-syndromic hearing loss., Conclusions: The types of GJB2 gene mutation were different and vary in Malay non-syndromic hearing loss as compared to the other races. Furthermore, the mutation did not associate with hearing loss in the population. Other related genes are believed to be involved and need to be sought in this group of patients., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Background: The mitochondrial DNA (mtDNA) 10398 polymorphism is hypothesised to alter a mitochondrial subunit of the electron transfer chain and is associated with several neurodegenerative disorders and cancers., Methods: In this study, an mtDNA polymorphism at nucleotide position 10398 was screened in 101 Malay female patients with invasive breast cancer and 90 age-matched healthy female controls using minisequencing analysis., Results: The Malay women with the 10398G variant showed a significantly increased risk of invasive breast cancer (OR = 2.29, 95% CI 1.25-4.20, P = 0.007). Immunohistochemistry analysis was conducted to investigate the effect of this polymorphism on the levels of apoptosis in breast cancer cells. The level of Bax (a pro-apoptotic protein) expression was significantly higher than that of Bcl-2 (an anti-apoptotic protein) in patients carrying the G allele (P = 0.016) but not in those carrying the A allele (P = 0.48)., Conclusion: Based on these findings, we propose that the mtDNA 10398 polymorphism may be a potential risk marker for breast cancer susceptibility in the Malay population.

In the organosolv pulping of the oil palm fronds, the influence of the operational variables of the pulping reactor (viz. cooking temperature and time, ethanol and NaOH concentration) on the properties of the resulting pulp (yield and kappa number) and paper sheets (tensile index and tear index) was investigated using a wavelet neural network model. The experimental results with error less than 0.0965 (in terms of MSE) were produced, and were then compared with those obtained from the response surface methodology. Performance assessment indicated that the neural network model possessed superior predictive ability than the polynomial model, since a very close agreement between the experimental and the predicted values was obtained., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Sclerosing lipogranuloma (SLG) of the male external genitalia is a rare benign condition presenting as subcutaneous masses. The underlying pathological process is a granulomatous reaction of fatty tissue in this area. The cause of this is unclear but hypothesis stems around the pathogenesis of exogenous lipid degeneration from injection of foreign bodies such as paraffin for penile augmentation. However, endogenous lipid degeneration from other various causes such as infection, trauma, and allergic mechanisms has also been reported. We present the case of a 40-year-old man with primary SLG of the external genitalia. Literature review on the treatment strategies are addressed and discussed.

Renal cancer is rare and its incidence is 1.9 per 100,000 in the Malaysian population, which consists of three major ethnic groups (Malay, Chinese and Indians). A retrospective study was her conducted to identify clinical characteristics and ethnic background influences on presentation. The study included all renal cancer patients from a single medical institution over ten years, with a total of 75 cases. Seventy-three patients underwent surgery while 2 received only radiotherapy or chemotherapy. The male to female ratio was 2.75:1. Incidence was equal among the Malay (49.3%) and Chinese ethnic groups (45.3%). Mean age of patients were 57.1 (18-93) years old. There were 26 (37.4%) patients with Stage I disease, 14 (18.7%) at Stage II, 23 (30.7%) at Stage III and 12 (16%) at Stage IV. The Chinese race presented at mean older age (p= 0.02) and later stage of disease (p= 0.046). Patients above 40 years old had more advanced stage disease (p= 0.023). Tumour histology were clear cell (72%), urothelial cell (13.3%), sarcomatoid cell and nephroblastoma each contributed 2.7%. The mean tumour size was 8.1 (2-20) cm. There was substantial agreement between the pre and post operative staging (kappa 0.691). In conclusion we observed significant influences of age and race in the clinical presentation of renal cancer in our institution based population. There was larger male to female ratio and mean tumour size as compared to previous epidemiology studies.

Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed.

Objectives: Large inter-subject variability in responses to eccentric exercise has been reported. This study investigated the hypothesis that the variability of changes in indirect markers of exercise-induced muscle damage (EIMD) would be explained by work performed and/or torque generated during eccentric exercise., Methods: Subjects (n = 53) performed 60 maximal eccentric actions of the elbow flexors on an isokinetic dynamometer that forcibly extended the elbow joint from 60 degrees to 180 degrees at a constant velocity (90 degrees s(-1)). Markers of EIMD included maximal voluntary isometric contraction torque at 90 degrees elbow flexion (MVC), range of motion, plasma creatine kinase activity and muscle soreness. Measurements were taken 2 days before, immediately after and 1-4 days post-exercise. Pearson's correlation coefficient was used to examine relationships between exercise parameters (total work, change in total work, torque produced during exercise, change in peak torque) and markers of EIMD., Results: Large inter-subject variability was evident for both work and torque during exercise, and changes in all markers of EIMD. Contrary to the hypothesis, total work (normalised for individual pre-exercise MVC) did not correlate significantly with any markers of EIMD, with the exception of MVC (r = 0.3). Total work performed and changes in total work showed higher correlations with some markers, but no r-values exceeded 0.4. Normalised exercise torque and the changes in peak torque during exercise were not correlated with changes in MVC, or other markers., Conclusion: These results suggest the large inter-subject variability in responses to eccentric exercise is not associated with work performed or torque generated during eccentric exercise.

Two tsunami survivors from Banda Acheh, Sumatra, presented with pyrexia of unknown origin and a nonresolving left-sided empyema, respectively. Both children had mixed infections of tuberculosis and melioidosis; Salmonella typhi was also present in the second patient. Mixed infections are common late sequela complications in post-tsunami victims.

A 7-year-old boy, referred with lymphoma, presented with prolonged fever and intra-abdominal lymphadenopathy demonstrated on computed tomography (CT) of the abdomen. Blood culture isolated Penicillium marneffei. The patient was subsequently proven serologically to be positive for human immunodeficiency virus (HIV). Treatment with amphotericin B followed by itraconazole was successful. A high level of clinical suspicion and awareness is necessary for early diagnosis of penicilliosis, especially in an era of an increasing prevalence of HIV in this region.

The precipitation patterns and characteristics of calcium phosphate (CaP) phases deposited on HEMA-based hydrogels upon incubation in simulated body fluid (SBF-2) containing a protein (human serum albumin) have been investigated in relation to the calcification in an organic-free medium (SBF-1) and to that occurring after subcutaneous implantation in rats. In SBF-2, the deposits occurred exclusively as a peripheral layer on the surface of the hydrogels and consisted mainly of "precipitated hydroxyapatite", a species deficient in calcium and hydroxyl ions, similarly to the deposits formed on the implanted hydrogels, where the deposited layer was thicker. In SBF-1, the deposits were mainly of brushite type. There was no evidence that albumin penetrated the interstices of hydrogels. As the X-ray diffraction patterns of the CaP deposits generated in SBF-2 showed a similar nature with those formed on the implanted hydrogel, it was concluded that the calcification in SBF-2 can mimic to a reliable extent the calcification process taking place in a biological environment.

Background: CYP2C9 is one of the major drug metabolizing enzymes for many drugs including warfarin, NSAIDs and losartan. It is polymorphic in many populations. Data on the distribution of CYP2C9 and the implication of CYP2C9 polymorphism in the Malaysian population is lacking. Our objectives were therefore to investigate the prevalence of CYP2C9 variants among unrelated healthy volunteers of Malays, Chinese and Indians in Malaysia., Method: Deoxyribonucleic acid was extracted using standard lysis methods. Allele specific polymerase chain reaction was performed for determination of CYP2C9*1, *2, *3, *4 and *5 variants according to Z. Zainuddin, L.K. Teh, A.W.M. Suhaimi, M.Z. Salleh, R. Ismail (2003, Clinica Chimica Acta, 336, 97)., Result: The Chinese had the highest frequency of CYP2C9*1 (321/330, 97.27%), followed by the Malays and the Indians (402 of 420, 95.71% and 291 of 330, 88.18%, respectively). CYP2C9*2 was not found in the Chinese. CYP2C9*3 were detected in all the three races with the Indians having the highest frequency of CYP2C9*3 (9.7%). The Indians had a frequency of CYP2C9*2 and *3 similar to Tamilians and Caucasians. Two of the Indians had *2/*3 and one had *3/*3 genotypes and are likely to be slow metabolizers. No subject with CYP2C9*4 and *5 were detected in our populations., Conclusion: CYP2C9*2 and *3 were identified in our population. Indians are similar to Caucasians in terms of CYP2C9 genotypes and thus may respond to CYP2C9 substrates differently when compared with the Malays and Chinese in Malaysia.

This study investigated the hypothesis that a bout of light concentric exercise (LCE) would alleviate delayed-onset muscle soreness (DOMS) and enhance recovery from muscle damage. Fourteen subjects performed two bouts of 60 maximal eccentric actions of the elbow flexors (Max-ECC) separated by 2-4 weeks. One arm performed LCE (600 elbow flexion and extension actions with minimal force generation) 1, 2, 3, and 4 d after Max-ECC; the contralateral (control) arm performed only Max-ECC. Changes in maximal isometric and isokinetic strength, range of motion (ROM), upper arm circumference, and muscle soreness and tenderness were assessed before and immediately after LCE bouts. Changes in these measures and plasma creatine kinase (CK) activity for 7 d after Max-ECC were compared between the control and LCE arms using 2-way repeated measures analysis of variance (ANOVA). Significant (p < 0.05) decreases in muscle soreness (approximately 40%) and tenderness (approximately 40%) were evident immediately after LCE, which also resulted in small but significant decreases in strength (approximately 15%) and increases in ROM (approximately 5 degrees ). No significant differences in the changes in the measures following Max-ECC were observed between the arms. These results suggest that LCE has a temporary analgesic effect on DOMS, but no effect on recovery from muscle damage.