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Clinical resolution of periodontitis among diabetic patients under medical-dental coordinated care: A preliminary study in Kuantan
No full textThe literature had reported the clinical resolution of periodontitis (CRP) in type-2 diabetic patients (T2DM-P) following non-surgical periodontal treatment (NSPT). However, the changes in glycemic control status during NSPT have not been presented clearly. Hence, this study was aimed to evaluate the CRP of T2DM-P under medical-and dental-coordinated care (M-DCC). A 6-month follow-up quasi-experimental study was conducted on 20 T2DM-P patients who underwent M-DCC in Kuantan. M-DCC, which included the standard diabetic care was administered by medical professionals at three health clinics, while NSPT by two periodontal specialists at their respective clinics. The target glycemic control achievement (TGCA), HbA1c. 6.5%. was assessed at 0 and 6 months post-NSPT. Clinical resolution of PD was measured in terms of the following parameters: (1) full mouth bleeding score (FMBS); (2) clinical attachment level (CAL) (mm); (3) probing pocket depth (PPD) (mm); as well as (4) PPDs of 0.05). NSPT, under M-DCC, gave rise to significant changes in the periodontal health of diabetic patients 6 months post-treatment. The effects of NSPT on HbA1c level were inconclusive. (WC:251). © 2019 University of Dicle
Flow visualization and analysis of thermal distribution for the nanofluid by the integration of fuzzy c-means clustering ANFIS structure and CFD methods
No full textAbstract: A nanofluid containing copper (Cu) nanoparticles was simulated in a rectangular cavity using computational fluid dynamic (CFD). The upper and lower walls of the cavity were adiabatic, while the right and left walls had warm and cold temperatures, respectively. This temperature difference causes a thermal flow from the right wall to the left wall. The elements of the coordination system in different directions, including velocity in the Y direction (V) and fluid temperature, were obtained using CFD. Adaptive network-based fuzzy inference system (ANFIS) was used to train the CFD outputs and provided artificial flow field and temperature distribution along the cavity domain. The CFD outputs were used as input and output data for the ANFIS method. The position of the fluid layer in X and Y computing directions and fluid velocity (Y axis) were used as three inputs, and the fluid temperature was taken as the output in the ANFIS method training process. The data were categorized using fuzzy c-means clustering, and different numbers of clusters were taken as a key parameter in this method. Using the fuzzy inference system, it is possible to predict the nodes in the cavity not generated through CFD simulation so that different coordination of the fluid at these points can be computed. Using ANFIS method, it is possible to reduce the computation time of CFD method so that more nodes are predicted in a shorter period of time, while clustering method can enhance the computing time for each neural cell. The ANFIS method can also visualize the flow in the cavity and display the thermal distribution along with the heat source. Graphic abstract: [Figure not available: see fulltext.]. © 2019, The Visualization Society of Japan
Estimation of the dietary intake and risk assessment of food carcinogens (3-MCPD and 1,3-DCP) in soy sauces by Monte Carlo simulation
No full textQuantifiable levels of 3-chloropropane-1,2-diol (3-MCPD) and 1,3-dichloro-2-propanol (1,3-DCP) were found in domestically manufactured soy-based sauces. Selected commercial foods in the Malaysian market (n = 43) were analyzed for their 3-MCPD and 1,3-DCP contents using a validated gas chromatography–mass spectrometry technique. The 3-MCPD and 1,3-DCP contents of the analyzed food samples varied from not detectable levels to 0.1223 ± 0.0419 mg kg−1 and not detectable levels to 0.025 ± 0.0041 mg kg−1, respectively. High concentrations of 3-MCPD, exceeding Malaysia's maximum tolerable limit of 0.02 mg kg−1, were found in chicken seasoning cubes (mean = 0.0898 ± 0.0378 mg kg−1). Monte Carlo simulation-based health risk assessment revealed that 3-MCPD and 1,3-DCP intakes in the 50th, 95th, and 99th percentiles were lower than 4 µg kg−1 bw day−1, the limit recommended by JECFA in 2016. Hence, it was concluded that the exposure of Malaysian citizens to chloropropanols through soy sauce consumption does not present a health risk. © 2019 Elsevier Lt
United in Fight against prOstate cancer (UFO) registry: first results from a large, multi-centre, prospective, longitudinal cohort study of advanced prostate cancer in Asia
No full textObjectives: To document the management of advanced prostate cancer including diagnosis, prognosis, treatment, and care, in real-world practice in Asia using the United in Fight against prOstate cancer (UFO) registry. Patients and Methods: We established a multi-national, longitudinal, observational registry of patients with prostate cancer presenting to participating tertiary care hospitals in eight Asian countries. A total of 3636 eligible patients with existing or newly diagnosed high-risk localised prostate cancer (HRL), non-metastatic biochemically recurrent prostate cancer (M0), or metastatic prostate cancer (M1), were consecutively enrolled and are being followed-up for 5 years. Patient history, demographic and disease characteristics, treatment and treatment decisions, were collected at first prostate cancer diagnosis and at enrolment. Patient-reported quality of life was prospectively assessed using the European Quality of Life-five Dimensions, five Levels (EQ-5D-5L) and Functional Assessment of Cancer Therapy for Prostate Cancer questionnaires. In the present study, we report the first interim analysis of 2063 patients enrolled from study start (15 September 2015) until 18 May 2017. Results: Of the 2063 enrolled patients, 357 (17%), 378 (19%), and 1328 (64%) had HRL, M0 or M1 prostate cancer, respectively. The mean age at first diagnosis was similar in each group, 56% of all patients had extracapsular extension of their tumour, 28% had regional lymph node metastasis, and 53% had distant metastases. At enrolment, 62% of patients had at least one co-morbidity (mainly cardiovascular disease or diabetes), 91.8% of M1 patients had an Eastern Cooperative Oncology Group performance score of <2 and the mean EQ-5D-5L visual analogue score was 74.6–79.6 across cohorts. Treatment of M1 patients was primarily with combined androgen blockade (58%) or androgen-deprivation therapy (either orchidectomy or luteinising hormone-releasing hormone analogues) (32%). Decisions to start therapy were mainly driven by treatment guidelines and disease progression. Decision to discontinue therapy was most often due to disease progression (hormonal drug therapy) or completion of therapy (chemotherapy). Conclusion: In the UFO registry of advanced prostate cancer in Asia, regional differences exist in prostate cancer treatment patterns that will be explored more deeply during the follow-up period; prospective follow-up is ongoing. The UFO registry will provide valuable descriptive data on current disease characteristics and treatment landscape amongst patients with prostate cancer in Asia. © 2019 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU Internationa
MCLMR: A Multicriteria Based Multipath Routing in the Mobile Ad Hoc Networks
No full textIn Mobile Ad hoc Networks (MANETs), nodes’ mobility, traffic congestion, and link quality estimation of the intermediate nodes are very crucial factors for establishing a reliable forwarding path between a source and destination node pairs. The unpredictable movement of nodes and random data traffic flow at a single node can cause congestion and network topology instability, which significantly lowers the performance of the ad hoc network. Indeed, the above-highlighted issues can be mitigated by implementing a more reliable mobility-centric, contention, and link quality-aware routing protocol for efficient data transmissions in a mobile network. This paper proposes a routing strategy called Mobility, Contention window, and Link quality sensitive multipath Routing (MCLMR) in MANETs, which considers the nodes mobility, contention window size, and link quality estimated value of the intermediate nodes in the optimal route selection. Also, Technique for Order of Preference by Similarity to Ideal Solution; a multicriteria decision-making technique, which provides weights according to node mobility, contention window size, and link quality estimated values, is also employed for the selection of intermediate nodes, whereas the Expected Number of Transmissions metric is used to minimize the effect of control message storm. The extensive simulations results prove that the proposed MCLMR routing scheme outperforms the conventional Multipath Optimized Link State Routing (MP-OLSR) and MP-OLSRv2 routing schemes in terms of network throughput, end-to-end delay, energy consumption, and packets loss ratio. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Association Between Myocardial Injury and Cardiovascular Outcomes of Orthopaedic Surgery
No full textBACKGROUND: Myocardial injury after noncardiac surgery (MINS) is common and of prognostic importance. Little is known about MINS in orthopaedic surgery. The diagnostic criterion for MINS was a level of ≥0.03 ng/mL on a non-high-sensitivity troponin T (TnT) assay due to myocardial ischemia. METHODS: We undertook an international, prospective study of 15,103 patients ≥45 years of age who had inpatient noncardiac surgery; 3,092 underwent orthopaedic surgery. Non-high-sensitivity TnT assays were performed on postoperative days 0, 1, 2, and 3. Among orthopaedic patients, we determined (1) the prognostic relevance of the MINS diagnostic criteria, (2) the 30-day mortality rate for those with and without MINS, and (3) the probable proportion of MINS cases that would go undetected without troponin monitoring because of a lack of an ischemic symptom. RESULTS: Three hundred and sixty-seven orthopaedic patients (11.9%) had MINS. MINS was associated independently with 30-day mortality including among those who had had orthopaedic surgery. Orthopaedic patients without and with MINS had a 30-day mortality rate of 1.0% and 9.8%, respectively (odds ratio [OR], 11.28; 95% confidence interval [CI], 6.72 to 18.92). The 30-day mortality rate was increased for patients with MINS who had an ischemic feature (i.e., symptoms, or evidence of ischemia on electrocardiography or imaging) (OR, 18.25; 95% CI, 10.06 to 33.10) and for those who did not have an ischemic feature (OR, 7.35; 95% CI, 3.37 to 16.01). The proportion of orthopaedic patients with MINS who were asymptomatic and in whom the myocardial injury would have probably gone undetected without TnT monitoring was 81.3% (95% CI, 76.3% to 85.4%). CONCLUSIONS: One in 8 orthopaedic patients in our study had MINS, and MINS was associated with a higher mortality rate regardless of symptoms. Troponin levels should be measured after surgery in at-risk patients because most MINS cases (>80%) are asymptomatic and would go undetected without routine measurements. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence
Left behind malaysian aged parents and their experiences with adult children’s migration
No full textMigration is a widespread phenomenon throughout the world and it has been under way since time immemorial. While studies have focused on the causes of migration and the impact of migrants, studies focusing on the emotional experience of the left-behind older persons’ adjustments in their twilight years after the departure of their adult children, are few and far between. Thus, the perspectives of these left-behind older parents/ persons are less understood. This paper aims to contribute to the literature by addressing the gap which will be filled through the experiences of left-behind Malaysian older persons. Drawing on in-depth interviews extracted from a qualitative study that focused on the strength of long-term marriages among Malaysian Chinese couples, this paper captures four older couples’ experiences that depict their feelings about their adult children’s migration. Analysis suggests that the children’s migration was induced by a lack of support and resources, followed by unequal educational opportunities. To deal with the gap left by their children, these older urban parents depend on kinship connection and community support in times of need. Government initiatives may also be able to empower the community in innovating and implementing plans which are tailored to the needs of the older parents left behind by children who have migrated. The living arrangements and recent bereavement experiences captured from the older couples can serve as cues for healthcare professionals and social support providers to assess the risks of social isolation and suicide among these left-behind older parents. © 2020, Faculty of Medicine, University of Malaya. All rights reserved
Utilisation of biomass wastes based activated carbon supported heterogeneous acid catalyst for biodiesel production
No full textThis study evaluated the utilisation of biomass wastes as catalyst supports by comparing the catalytic performance of papaya seed, empty fruit bunch (EFB) and corncob biomass waste derived carbon based acid catalysts applied for biodiesel production through esterification reaction of palm fatty acid distillate (PFAD) and methanol. Arylation of 4-benzenediazonium sulfonate synthesis method was able to sulfonate the catalyst support efficiently. The activated carbon (AC) synthesised possessed high porosity with surface area ranged between 639.68 and 972.66 m2/g. The effect of catalyst synthesising condition including carbonisation temperature (600–1000 °C), sulfonation time (0.5–2.5 h) and sulfanilic acid to AC weight ratio (3:1–13:1) towards the FAME yield and free fatty acid (FFA) conversion were evaluated. At the optimum catalyst synthesis conditions, corncob waste derived sulfonated AC catalyst exhibited the highest FAME yield and FFA conversion of 72.09% and 93.49%, respectively. Reusability study showed that corncob waste derived sulfonated AC catalyst was able to achieve relatively high FAME yield at the first two reaction cycles. The esterification reaction followed the irreversible pseudo-homogeneous reaction model. The high catalytic efficiency of the catalyst had shown its high potential to fit into the cost-effective and sustainable framework for biodiesel production. © 2020 Elsevier Lt
Inapparent dengue in a community living among dengue-positive Aedes mosquitoes and in a hospital in Klang Valley, Malaysia
No full textThe public health burden of dengue is most likely under reported. Current dengue control measures only considered symptomatic dengue transmission. Hence, there is a paucity of information on the epidemiology of inapparent dengue. This study reports that many people have been unknowingly exposed to dengue infection. Almost 10% and 70% of individuals without any history of dengue infection and living in a dengue hotspot, in Selangor, Malaysia, were dengue IgM and IgG positive respectively. When dengue-positive mosquitoes were detected in the hotspot, 11 (6.3%) of the 174 individuals tested were found to have dengue viremia, of which 10 were asymptomatic. Besides, upon detection of a dengue-infected mosquito, transmission was already widespread. In a clinical setting, it appears that people living with dengue patients have been exposed to dengue, whether asymptomatic or symptomatic. They can either have circulating viral RNA and/or presence of NS1 antigen. It is also possible that they are dengue seropositive. Collectively, the results indicate that actions taken to control dengue transmission after the first report of dengue cases may be already too late. The current study also revealed challenges in diagnosing clinically inapparent dengue in hyperendemic settings. There is no one best method for diagnosing inapparent dengue. This study demonstrates empirical evidence of inapparent dengue in different settings. Early dengue surveillance in the mosquito population and active serological/virological surveillance in humans can go hand in hand. More studies are required to investigate the epidemiology, seroprevalence, diagnostics, and control of inapparent dengue. It is also crucial to educate the public, health staff and medical professionals on asymptomatic dengue and to propagate awareness, which is important for controlling transmission. © 2020 Elsevier B.V
Photocatalytic performance of novel chromium oxide-silicon dioxide decorated on multi-walled carbon nanotubes and graphene oxide nanocomposites: Preparation, structural, and optimization
No full textIn this project, we successfully prepared Cr2O3-SiO2/graphene oxide (GO) or multi-walled carbon nanotubes (MWCNTs) by microwave/ultrasonic/hydrothermally method, aiming for the photo-degradation capture of Parathion compound from aqueous solutions. For the removal of Parathion, the photocatalysis properties is different and the apparent degradation amount sequence is SiO2 < Cr2O3-SiO2 < Cr2O3-SiO2/MWCNTs < Cr2O3-SiO2/GO nano-catalyst. Compared with bare SiO2 particles, Cr2O3-SiO2, and Cr2O3-SiO2/MWCNTs, the prepared Cr2O3-SiO2/GO exhibits the excellent photocatalytic performance for the UV light degradation of Parathion compound. The maximum photo-degradation of Parathion by Cr2O3-SiO2/GO was carried out after 60 min of contact time under UV light. The response surface method with box-behnken design was used to optimization of Parathion photo-degradation. Moreover, the good stability and convenient recycling of the prepared Cr2O3-SiO2/MWCNTs and Cr2O3-SiO2/GO nanocomposites further make it have excellent application aim in removal of organic pollution. © 2019 Elsevier B.V