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Finding the sparse solution to under-determined or ill-condition equations is a fundamental problem encountered in most applications arising from a linear inverse problem, compressive sensing, machine learning and statistical inference. In this paper, inspired by the reformulation of the ?1-norm regularized minimization problem into a convex quadratic program problem by Xiao et al. (Nonlinear Anal Theory Methods Appl, 74(11), 3570-3577), we propose, analyze, and test a derivative-free conjugate gradient method to solve the ?1-norm problem arising from the reconstruction of sparse signal and image in compressive sensing. The method combines the MLSCD conjugate gradient method proposed for solving unconstrained minimization problem by Stanimirovic et al. (J Optim Theory Appl, 178(3), 860-884) and a line search method. Under some mild assumptions, the global convergence of the proposed method is established using the backtracking line search. Computational experiments are carried out to reconstruct sparse signal and image in compressive sensing. The numerical results indicate that the proposed method is stable, accurate and robust.

COVID-19 pandemic has an impact on the quality of life (QoL) of the young people by affecting their psychological stress and suspicion of diagnosis with post-traumatic stress disorder PTSD. In response to this global health crisis, quarantine and lock down measures were implemented by international and government health organizations to contain the rapid spread of the virus. Such a period of health crisis has significant repercussions on human health and welling, accompanied by psychological distress and related symptoms such as stress, panic and anxiety in the general population specifically students. Therefore, this study aimed to study association between COVID-19 pandemic and lock down with post-traumatic stress disorder.

An excellent all-weather road is essential in providing reliable transportation services that comprise social and economic development elements. However, in most cases, the road has to be constructed on a soft foundation soil where large deformations usually occur, which causes increases in maintenance costs and leads to interruption of traffic service, especially during the wet season. It is necessary to stabilize or improve the in-situ soils. This study explores the potential of using metakaolin to improve the geotechnical properties of lateritic soil for road construction materials. The soil classifies as A-6(4) and CL according to the American Association of State Highway and Transport Officials and the Unified Soil Classification System. The soil was treated with 5, 17.5 and 30 % concentrations of metakaolin by dry weight and was compacted using three compaction energies: British Standard Light (BSL), West African Standard (WAS) and British Standard Heavy (BSH). California Bearing Ratio (CBR) and Unconfined Compressive Strength (UCS) tests were carried out to evaluate the effect of metakaolin on the soil investigated. Results showed a general improvement in the engineering properties of the soil with an increase in metakaolin content, particularly when compacted at the BSH energy level. However, the results did not meet the 1500-3000 kN/m2 7 days UCS criterion stipulated by the Nigerian General Specification for road base courses. However, 30 % lateritic soil/metakaolin blended soil compacted using WAS and BSH energy levels suffice for use as sub-base in road construction, having met the 750-1500 kN/m2 7 days UCS criterion stipulated by the Nigerian General Specification. The Peak CBR value for the treated soil, compacted using the three energy levels of BSL, WAS, and BSH, occurred at 30 % metakaolin concentration with corresponding soaked CBR values of 17, 23 and 31 %. The Nigerian General Specification recommends a nominal strength criterion of a soaked CBR value of 30 and 80 % to be attained by material to be used as sub-base and base course in road construction. Based on the above criterion, only the 30 % metakaolin treated blend compacted at the BSH energy level met the 30 % requirement for sub-base materials.

This study evaluates the removal efficiency of Fe and Mn from primary treated municipal wastewater using new electrodes configuration in electrocoagulation (EC) process. The used electrodes configuration generates a dielectrophoretic (DEP) force in an EC process. The effect of the electrolysis time, electrodes spacing and current density on the removal of Fe and Mn was studied. The maximum removal of Fe and Mn were obtained using operational time of 60 min, electrodes spacing of 0.5 cm and an applied current of 800 mA. Under these operating conditions and using the new electrodes configuration, the Fe and Mn removals were 96.8% and 66%, respectively. The main advantage of using the DEP induced electrode configuration was the minimal consumption of the electrodes. The new electrode configuration showed 42% less aluminum content in the reactor compared to the aluminum electrodes without DEP effect. Moreover, the energy consumption at the selected operation conditions was 4.88 kWh/m3. Additionally, the experimental results were compared with the simulation results of the new electrodes configuration done by COMSOL software

Heads of government in Africa responded to the COVID-19 pandemic by setting up high-level task forces at continental and national levels to coordinate preparedness and response strategies, in a bid to mitigate the spread of this virus on the continent. However, the current strategy at both continental and national levels are narrowly focused on COVID-19 and this is not sustainable. This is because Africa has a high burden of communicable and non-communicable diseases and sustaining access to essential life-saving health services is also critical during this pandemic. Therefore, we call for a more holistic health systems-based model for COVID-19 outbreak response. We recommend that response strategies should be transitioned from vertical isolated programmes to a broad-based "time-bound" integrated health system intervention that links with existing health programmes as well as other government and non-governmental sectors.

In this article, we presented clinical and histological findings of a very rare case of metastatic bilateral synchronous giant Krukenberg tumor (KT) in very young age and presented with ileus, abdominal pain and swelling. Descending colon tumor, peritoneitis carcinomatosa (PC), bilateral ovarian giant tumor were detected during the emergency operation for ileus. Histomorphologically, the primary focus of bilateral ovarian tumors and PC was located in the descending colon. There was microscopic examination revealed mucinous adenocarcinoma (MAC) accompanied by signet ring cell carcinoma, diffusely invading the ovarian parenchyma in bilateral ovaries. In these case the choice of treatment is more difficult and prognosis is also worse with fatal outcome in one year. Early diagnosis, complete resection and intraoperative chemotherapy are the only possible hope.

Introduction: Dopamine receptor D2 (DRD2) is one of the dopamine receptors that have been studied in relation to opioid dependence. It is possible, therefore, that DRD2 gene (DRD2) polymorphisms influence treatment outcomes of patients with opioid dependence. The objective of this study was to investigate the influence of DRD2 polymorphisms on the clinical outcomes of opioid-dependent patients on methadone maintenance therapy (MMT). Materials and Methods: Patients with opioid dependence (n = 148) were recruited from MMT clinics. Pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality were assessed using cold pressor test (CPT), Subjective Opiate Withdrawal Scale (SOWS-M), and Pittsburgh Sleep Quality Index (PSQI)-Malay, respectively. Deoxyribonucleic acid (DNA) was extracted from whole blood, and then was used for genotyping of Val96Ala, Leu141Leu, Val154Ile, Pro310Ser, Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms. Results: Among 148 patients, 8.1% (n = 12), 60.8% (n = 90), 27.7% (n = 41), and 29.1% (n = 43) had at least one risk allele for Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms, respectively. There were no significant differences in pain responses (pain threshold, tolerance, and intensity), SOWS, and PSQI scores between DRD2 polymorphisms. Conclusion: The common DRD2 polymorphisms are not associated with pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality in patients with opioid dependence on MMT. However, this may be unique for Malays. Additional research should focus on investigating these findings in larger samples and different ethnicity.

Background: Endogenous and exogenous opioids are substrates of the permeability glycoprotein (P-gp) efflux transporter, which is encoded by the ABCB1 (MDR1) gene. Genetic polymorphisms of ABCB1 may contribute to interindividual differences in pain modulation and analgesic responses. We investigated the relationship between ABCB1 polymorphisms and cold pain sensitivity among healthy males. Methods: Cold pain responses, including pain threshold and pain tolerance, were measured using the cold-pressor test (CPT). DNA was extracted from whole blood and genotyped for ABCB1 polymorphisms, including c.1236C>T (rs1128503), c.2677G>T/A (rs2032582), and c.3435C>T (rs1045642), using the allelic discrimination real-time polymerase chain reaction. Results: A total of 152 participants were recruited in this observational study. Frequencies of mutated allele for c.1236C>T, c.2677G>T/A, and c.3435C>T polymorphisms were 56.6%, 49.7%, and 43.4%, respectively. Our results revealed an association of the CGC/CGC diplotype (c.1236C>T, c.2677G>T/A, and c.3435C>T) with cold pain sensitivity. Participants with the CGC/CGC diplotype had 90% and 72% higher cold pain thresholds (87.62 seconds vs. 46.19 seconds, P = 0.010) and cold pain tolerances (97.24 seconds vs. 56.54 seconds, P = 0.021), respectively, when compared with those without the diplotype. Conclusion: The CGC/CGC diplotype of ABCB1 polymorphisms was associated with variability in cold pain threshold and pain tolerance in healthy males.

Opioidergic system involves in regulation of sleep and wakefulness. It is possible, therefore, that genetic polymorphisms in OPRM1 influence sleep quality. This study investigated the association of OPRM1 polymorphisms with subjective sleep quality among opioid-naive individuals. This cross-sectional observational study involved 161 opioid-naive males (mean age = 27.74 years; range: 18−63 years). Subjective sleep quality was assessed with the translated and validated Malay version of the Pittsburgh Sleep Quality Index (PSQI). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR)-genotyping for two OPRM1 polymorphisms (118A>G and IVS2+691G>C). Subjects with combined 118A and IVS2+691G alleles (AC haplotype) had significantly lower PSQI scores [mean (SD) = 4.29 (1.76)] compared to those without the haplotype [4.99 (2.50)] (p = 0.004). On the other hand, subjects with combined heterozygous genotype (GC/AG diplotype) had significantly higher PSQI scores compared to those without the diplotype [6.04 (2.48) vs 4.54 (2.22), p = 0.004]. In opioid-naive individuals, AC haplotype and GC/AG diplotype for the 118A>G and IVS2+691G>C polymorphisms of OPRM1 are associated with better and poorer sleep quality, respectively.

Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose. Serum methadone concentrations were measured using the Methadone ELISA kit and classified into two categories: < 400 ng/mL and ≥ 400 ng/mL. Eighty-eight patients (59.9%) had trough concentrations of < 400 ng/mL and 40.1% had trough concentrations of ≥ 400 ng/mL. There were significant effects of SMC on the cold pressor pain threshold (p = 0.019). Patients with concentrations < 400 ng/mL had significantly higher (almost 60% higher) cold pressor pain threshold (adjusted mean (95% CI) = 30.15 (24.29, 36.01) s) compared to those with concentrations of ≥ 400 ng/mL (18.93 (11.77, 26.08) seconds). There was also a 20% difference in pain tolerance, and 6% difference in cold pressor pain intensity score, neither of which were significant statistically (p > 0.05). Our results suggest an association of trough methadone concentration with the cold pressor pain threshold among opioid dependent patients on MMT. It would be useful to study the mechanisms underlying this association to help managing pain in such a population.

Several innovations that can improve immunization systems already exist. Some interventions target service consumers within communities to raise awareness, build trust, improve understanding, remind caregivers, reward service users, and improve communication. Other interventions target health facilities to improve access and quality of vaccination services among others. Despite available empirical evidence, there is a delay in translating innovations into routine practice by immunization programmes. Drawing on an existing implementation science framework, we propose an interactive, and multi-perspective model to improve uptake and utilization of available immunization-related innovations in the African region. It is important to stress that our framework is by no means prescriptive. The key intention is to advocate for the entire immunization system to be viewed as an interconnected system of stakeholders, so as to foster better interaction, and proactive transfer of evidence-based innovation into policy and practice.

Introduction We recently reported that a majority of opioid-dependent Malay males on methadone therapy are cold pain sensitive. It is postulated that common OPRM1 polymorphisms may be responsible. This study investigated the association between 118A>G (dbSNP rs1799971) and IVS2+691G>C (dbSNP rs2075572) variants on cold pain responses among opioid-dependent Malay males on methadone maintenance therapy. Methods Cold pain responses including pain threshold, pain tolerance, and pain intensity were measured using the cold pressor test. DNA was extracted from the venous blood before polymerase chain reaction genotyping. Repeated measures analysis of variance was used to compare the cold pain responses and OPRM1 polymorphisms (118A>G and IVS2+691G>C) using models including genotype dominant and recessive models, allelic additive models, and analysis of haplotypes and diplotypes. Results A total of 148 participants were recruited. With the recessive model, those with IVS2+691 homozygous CC genotype had a shorter cold pain tolerance time than those without CC genotype (i.e., GG/GC genotype; 29.81 vs. 43.08 s, respectively, P = 0.048). On the other hand, with diplotype analysis, participants with combined homozygous 118 AA genotype and heterozygous IVS2+691 GC genotype (i.e., AC/AG diplotype) had a longer cold pain tolerance time than those without this diplotype (49.34 vs. 31.48 s, respectively, P = 0.043). Cold pain threshold was not associated with any of the 118A>G and IVS2+691G>C variations despite being analyzed using various models (all P > 0.05). Conclusion The IVS2+691 CC genotype and AC/AG diplotype of 118A>G and IVS2+691G>C seem to have opposing roles in pain tolerance among opioid-dependent Malay males on methadone therapy. Haplotypes of OPRM1 may be associated with altered binding affinity. Electronic supplementary material The online version of this article (doi:10.1007/s40122-015-0041-y) contains supplementary material, which is available to authorized users.

Methadone is a substrate of the P-glycoprotein efflux transporter, which is encoded by ABCB1 (MDR1), and thus, ABCB1 polymorphisms may influence the transport of methadone at the blood-brain barrier, affecting its adverse effects.This study investigated the association between ABCB1 polymorphisms and cold pressor pain responses among opioid-dependent patients on methadone maintenance therapy (MMT).Malay male opioid-dependent patients receiving MMT (n = 148) were recruited. Cold pressor pain responses (pain threshold, pain tolerance, and pain intensity) were measured at 0, 2, 4, 8, 12, and 24 hours post-methadone dose. DNA was extracted from whole blood and genotyped for ABCB1 polymorphisms including 1236CT (rs1128503), 2677GT/A (rs2032582), and 3435CT (rs1045642) using the allelic discrimination real-time polymerase chain reaction. Repeated-measure analysis of variance between-group analysis was used to compare the three cold pressor pain responses and ABCB1 polymorphisms (1236CT, 2677GT/A, and 3435CT) according to genotypes and allelic additive models, genotype dominant and recessive models, haplotypes, and diplotypes.Patients with 2677 GG or 2677G allele had the lowest pain threshold compared with 2677GT/A genotypes or alleles (p = .007 and .002, respectively). Haplotype analysis showed a significant association between ABCB1 haplotypes and pain threshold (p = .02). Patients with 2677G allele had the lowest pain tolerance compared to those with 2677T and 2677A alleles (2677G2677T2677A allele carriers; p = .05). In terms of pain intensity scores, patients with 2677 GG or 2677G allele had the highest scores compared to other 2677GT/A genotypes or alleles (p = .04 and .008, respectively). Haplotype analysis revealed a significant difference between patients with CGC haplotype and those without this haplotype (p = .02).To the best of our knowledge, this study provides the first evidence that ABCB1 polymorphisms are associated with cold pressor pain responses among Malay male patients with opioid dependence on MMT. The results may provide an initial prediction on heightened pain sensitivity or hyperalgesia for individuals who are carriers of the ABCB1 polymorphisms.

Introduction: Dopamine receptor D2 (DRD2) is one of the dopamine receptors that have been studied in relation to opioid dependence. It is possible, therefore, that DRD2 gene (DRD2) polymorphisms influence treatment outcomes of patients with opioid dependence. The objective of this study was to investigate the influence of DRD2 polymorphisms on the clinical outcomes of opioid-dependent patients on methadone maintenance therapy (MMT). Materials and Methods: Patients with opioid dependence (n = 148) were recruited from MMT clinics. Pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality were assessed using cold pressor test (CPT), Subjective Opiate Withdrawal Scale (SOWS-M), and Pittsburgh Sleep Quality Index (PSQI)-Malay, respectively. Deoxyribonucleic acid (DNA) was extracted from whole blood, and then was used for genotyping of Val96Ala, Leu141Leu, Val154Ile, Pro310Ser, Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms. Results: Among 148 patients, 8.1% (n = 12), 60.8% (n = 90), 27.7% (n = 41), and 29.1% (n = 43) had at least one risk allele for Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms, respectively. There were no significant differences in pain responses (pain threshold, tolerance, and intensity), SOWS, and PSQI scores between DRD2 polymorphisms. Conclusion: The common DRD2 polymorphisms are not associated with pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality in patients with opioid dependence on MMT. However, this may be unique for Malays. Additional research should focus on investigating these findings in larger samples and different ethnicity.

Methadone is a substrate of the permeability glycoprotein (P-gp) efflux transporter, which is encoded by the ABCB1 (MDR1) gene. Large interindividual variability in serum methadone levels for therapeutic response has been reported. Genetic variations in ABCB1 gene may be responsible for the variability in observed methadone concentrations.This study investigated the associations of ABCB1 polymorphisms and serum methadone concentration over the 24-hour dosing interval in opioid-dependent patients on methadone maintenance therapy (MMT).One hundred and forty-eight male opioid-dependent patients receiving MMT were recruited. Genomic deoxyribonucleic acid (DNA) was extracted from whole blood and genotyped for ABCB1 polymorphisms [i.e. 1236CT (dbSNP rs1128503), 2677GT/A (dbSNP rs2032582), and 3435CT (dbSNP rs1045642)] using the allelic discrimination real-time polymerase chain reaction (PCR). Blood samples were collected at 0, 0.5, 1, 2, 4, 8, 12, and 24 hours after the dose. Serum methadone concentrations were measured using the Methadone ELISA Kit.Our results revealed an association of CGC/TTT diplotype (1236CT, 2677GT/A, and 3435CT) with dose-adjusted serum methadone concentration over the 24-hour dosing interval. Patients with CGC/TTT diplotype had 32.9% higher dose-adjusted serum methadone concentration over the 24-hour dosing interval when compared with those without the diplotype [mean (SD) = 8.12 (0.84) and 6.11 (0.41) ng mlThere was an association between the CGC/TTT diplotype of ABCB1 polymorphisms and serum methadone concentration over the 24-hour dosing interval among patients on MMT. Genotyping of ABCB1 among opioid-dependent patients on MMT may help individualize and optimize methadone substitution treatment.

Background CYP2B6 polymorphisms contribute to inter-individual variations in pharmacokinetics of methadone. Increased pain sensitivity is frequently reported by opioid dependent patients on methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in CYP2B6, which affects the metabolism of methadone, influence pain sensitivity among patients on MMT. This study investigated CYP2B6 polymorphisms and pain sensitivity in this group. Methods The cold pressor pain responses of 148 opioid dependent patients receiving MMT were evaluated using the cold pressor test (CPT). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR)-genotyping. Results Of the 148 subjects, 77 (52.0%) were carriers of CYP2B6*6 allele. CYP2B6*6 allele carriers had shorter cold pain threshold and pain tolerance times than non-carriers of CYP2B6*6 allele (21.05 s vs 33.69 s, p = 0.036 and 27.15 s vs 44.51 s, p = 0.020, respectively). Pain intensity scores of the CYP2B6*6 allele carriers was 67.55, whereas that of the CYP2B6*6 allele non-carriers was 64.86 ( p = 0.352). Conclusion Our study indicates that the CYP2B6*6 allele is associated with a lower pain threshold and lower pain tolerance among males with opioid dependence on MMT. The CYP2B6*6 allele may provide a mechanistic explanation for clinical observations of heightened pain sensitivity among opioid dependent patients receiving MMT.

Background/aim: Sleep disturbances may contribute to poor treatment outcomes in opioid-dependent patients. The extent to which the sleep profiles of opioid-dependent patients differ from those of the general Malaysian population is not documented. This study compared opioid-naive subjects and opioid-dependent patients on methadone maintenance therapy (MMT) in terms of their sleep quality. Materials and methods: Participants comprised Malay male opioid-naive subjects (n = 159) and opioid-dependent patients (n = 160) from MMT clinics in Kelantan, Malaysia, between March and October 2013. Sleep quality was evaluated using the translated and validated Malay version of the Pittsburgh Sleep Quality Index (PSQI). Results: The opioid-dependent patients exhibited higher global PSQI scores [adjusted mean (95% CI) = 5.46 (5.02, 5.90)] than the opioid-naive group [4.71 (4.26, 5.15)] [F (1, 313) = 4.77, P = 0.030]. Conclusion: This study confirmed the poorer sleep quality among opioid-dependent patients on MMT, as manifested by their higher global PSQI scores. The sleep complaints in this patient population are a factor to consider and, when necessary, sleep evaluation and treatment should be undertaken to improve MMT patients’ quality of sleep and overall treatment outcome.

Heightened pain sensitivity was frequently reported in opioid dependent patients on methadone maintenance therapy (MMT). This study investigated the influence of OPRM1 polymorphisms on pain sensitivity. Subjects were 148 Malay male opioid dependent patients receiving MMT. Their pain threshold (time elapsed when the subject started to perceive pain after immersion of hand), tolerance (time required for hand withdrawal), and intensity (0 - 100 visual analogue scale (VAS)) in response to cold pressor test (CPT) were measured at 0 hour (i.e. the time of the first CPT, and at 2, 4, 8, 12, and 24 hours after that. DNA was extracted from blood and subjected to PCR-genotyping. The differences of CPT responses between the OPRM1 polymorphisms were analysed using repeated measure analysis of variance (RM-ANOVA). There were no significant differences of pain responses (pain threshold, tolerance and intensity) between 118A > G and IVS2 + 691G > C polymorphisms of OPRM1 among opioid depedent subjects using genotype and allelic additive model, genotype dominant and recessive model, haplotypes and diplotypes analysis. The results suggest that the OPRM1 polymorphisms were not associated with differences in pain sensitivity. However, further investigations in larger numbers, other populations and pain models are required to confirm these findings.

Introduction Methadone is a full agonist of the opioid receptor mu 1 which is encoded by the OPRM1 gene. Sleep disorders were frequently reported by opioid-dependent patients during methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in OPRM1 influence sleep quality among patients on MMT. This study investigated the association of OPRM1 polymorphisms with sleep quality among opioid-dependent patients on MMT. Methods The sleep quality of 165 male opioid-dependent patients receiving MMT was evaluated using the Pittsburgh Sleep Quality Index (PSQI). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR) genotyping. Results Patients with IVS2 + 691 CC genotype had higher PSQI scores [mean (SD) = 5.73 (2.89)] compared to those without the IVS2 + 691 CC genotype (IVS2 + 691 GG/GC genotype) [4.92 (2.31)], but the difference did not reach statistical significance (p = 0.081). Patients with combined 118 AA genotype and IVS2 + 691 GC genotype (AC/AG diplotype) had significantly lower PSQI scores [mean (SD) = 4.25 (2.27)] compared to those without the diplotype [5.68 (2.77)] (p = 0.018). Conclusion Our study indicates that the AC/AG diplotype for the 118A>G and IVS2 + 691G>C polymorphisms of OPRM1 gene is associated with better sleep quality among males with opioid dependence on MMT.

Objectives: This study aimed to compare the QTc interval between low and high dose methadone groups and evaluate the pattern of QTc variation. Methods: This is a prospective cohort study conducted from December 2010 till August 2011 at Malaysian University of Science’s Hospital. Forty six subjects, grouped in high dose (>80mg) and low dose (