MGMT and SPOCK2 promoter methylation in diffuse large B-Cell lymphoma: a study in two tertiary health centres in the East Coast of Malaysia

MGMT (O6-Methylguanine-DNA Methyltransferase) suppresses tumor development by removing alkyl adduct, while SPOCK2 (SPARC/Osteonectin CWCV and Kazal-like domains proteoglycan) abolishes the inhibition of membrane-type matrix metalloproteinases (MT-MMP) which leads to angiogenesis. Hence, MGMT methylation may initiate malignant cells transformation. In contrast, SPOCK2 methylation is hypothesized not to be a common event in diffuse large B-cell lymphoma (DLBCL). In this study, we examined the methylation status of MGMT and SPOCK2 in DLBCL as in Malaysia the information is extremely lacking. A total of 88 formalin-fixed paraffin-embedded tissue of patients diagnosed with DLBCL from the year 2006 to 2013 were retrieved from Hospital Universiti Sains Malaysia, Kelantan and Hospital Tengku Ampuan Afzan, Pahang. Methylation-specific polymerase chain reaction (MSP) was used to examine the methylation status of both genes. Interestingly, methylation of MGMT was detected in all the 88 DLBCL samples, whereas SPOCK2 was found to be methylated in 83 of 88 (94.3%) DLBCL cases. Our study showed a remarkably high percentage of promoter methylation of both MGMT and SPOCK2 genes. Our finding also negates initial expectation that SPOCK2 methylation would be an uncommon event in the majority of DLBCL cases. This study has shown a very high percentage of promoter methylation of MGMT and SPOCK2 in the DLBCL cases studied by MSP, using archival lymphoma tissues. Nonetheless, additional research is needed to quantitatively evaluate MGMT and SPOCK2 methylation, and to analyse gene expression and/or protein expression in order to further understand the role of MGMT and SPOCK2 methylation in the pathogenesis of DLBCL

Tamadun Melayu Islam dan Pencapaian Teknologi

Budaya serta tamadun memainkan peranan yang sangat penting dalam mencorakkan rupa bentuk sesuatu bangsa atau masyarakat. Sejarah membuktikan bahawa kegemilangan peradaban dalam masyarakat Melayu masa silam terwujudnya daripada bangsa yang mempunyai jati diri dan berpegang teguh kepada ajaran Islam. Oleh itu, penulisan ini akan membincangkan konsep tamadun Melayu Islam dan pencapaian teknologi bagi kegemilangan sains dan teknologi yang dicapai oleh orang Melayu sangatlah unik kerana pencapaian ini mencerminkan keperluan serta nilai kebudayaan yang ada pada orang Melayu sendiri

Spread of Extensively Drug-Resistant Tuberculosis in KwaZulu-Natal Province, South Africa

Background In 2005 a cluster of 53 HIV-infected patients with extensively drug-resistant tuberculosis (XDR-TB) was detected in the Msinga sub-district, the catchment area for the Church of Scotland Hospital (CoSH) in Tugela Ferry, in KwaZulu-Natal province (KZN), South Africa. KZN is divided into 11 healthcare districts. We sought to determine the distribution of XDR TB cases in the province in relation to population density. Methods In this cross-sectional study, the KZN tuberculosis laboratory database was analysed. Results of all patients with a sputum culture positive for Mycobacterium tuberculosis from January 2006 to June 2007 were included. Drug-susceptibility test results for isoniazid, rifampicin, ethambutol, streptomycin, kanamycin and ofloxacin were available for all patients as well as the location of the hospital where their clinical diagnosis was made. Findings In total, 20858 patients attending one of 73 hospitals or their adjacent clinics had cultures positive for M. tuberculosis. Of these, 4170 (20%) were MDR-TB cases. Four hundred and forty three (11%) of the MDR tuberculosis cases displayed the XDR tuberculosis susceptibility profile. Only 1429 (34%) of the MDR-TB patients were seen at the provincial referral hospital for treatment. The proportion of XDR-TB amongst culture-confirmed cases was highest in the Msinga sub-district (19.6%), followed by the remaining part of the Umzinyati district (5.9%) and the other 10 districts (1.1%). The number of hospitals with at least one XDR-TB case increased from 18 (25%) to 58 (80%) during the study period. Interpretation XDR-TB is present throughout KZN. More than 65% of all diagnosed MDR-TB cases, including XDR-TB patients, were left untreated and likely remained in the community as a source of infection

Application of response surface methodology (RSM) in analyzing the hydrolytic degradation of plasticized MWCNTs nanocomposites

The present research goals are to investigate how several parameters became the factor to maximize the degradation ability of biopolymer. Multi-walled carbon nanotubes (MWCNTs) was blended in poly(lactic acid (PLA) assisted by poly(ethylene glycol) (PEG) as a plasticizer. PLA/PEG/mCNTs from the melt blending technique was used for analysis in hydrolysis degradation purposely to discover how the time, temperature and pH of media solution could affect the weight loss and validate by Response Surface Methodology (RSM). The hydrolysis study was examined at three parameters of immersion; time from 7 to 28 days; the temperature at 25 °C, 45 °C and 65 °C; and pH of the solution at pH 3 (HCl), pH 6.5 (deionized water) and pH 10 (NaOH). The maximum weight loss, 22.53 % was observed after 28 days of immersion at 65 °C of immersion temperature and pH 3 of solution. The quadratic model developed was reasonably accurate based on the R2 value of 0.966, insignificant lack of fit, and low percentage error during validation experiment from the predicted values (< 5 %)

Production of renewable diesel from Jatropha curcas oil via pyrolytic-deoxygenation over various multi-wall carbon nanotube-based catalysts

Jatropha curcas is a highly toxic plant that produces seed containing viscous oil with productivity (2 ton/ha), it grows in tropical and sub-tropical regions and offer greater adaptability to a wide range of climatic and soil conditions. Its oils have been noted as an important alternative to produce green diesel via deoxygenation reaction. This study, deoxygenation of jatropha curcas oil (JCO) was carried out over NiO–Fe2O3 and NiO–ZnO catalysts that supported onto multi-walled carbon nanotube (MWCNT). It had found that high Fe and Zn dosages were ineffective in deoxygenation and greatest activity was observed on NiO(20) Fe2O3(5)/MWCNT catalyst. Structure-activity correlations revealed that low metal loading, large density of weak + medium acidic sites and strong basic sites play key role in enhancing the catalytic activities and n-(C15+C17) selectivity. Comparing carbon nanostructures and carbon micron size supported NiO-Fe2O3 revealed that green diesel obtained from NiO–Fe2O3/MWCNT catalysed deoxygenation had the highest heating value and the lowest amounts of oxygen content. Thereby, it confirmed the importance of carbon nanostructure as the catalyst support in improving the diesel quality. Considering the high reusability of NiO-Fe2O3/MWCNT (6 consecutive runs) and superior green diesel properties (flash point, cloud properties and cetane index) demonstrated the NiO–Fe2O3/MWCNT catalyst offers great option in producing excellent properties of green diesel for energy sector

Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India.

BACKGROUND: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices. METHODS: We assessed data from 60 public health facilities in Uttar Pradesh, India, that received an 8-month staggered coaching intervention from December 2014 to September 2016 as part of the BetterBirth Trial, which is studying effectiveness of an SCC-centered intervention on maternal and neonatal harm. Nurse coaches recorded birth attendants' adherence to 39 essential birth practices. Practice adherence was calculated for each intervention month. After 2 months of coaching, a subsample of 15 facilities was selected for independent observation when the coach was not present. We compared adherence to the 18 practices recorded by both coaches and independent observers. RESULTS: Coaches observed birth attendants' behavior during 5,971 deliveries. By the final month of the intervention, 35 of 39 essential birth practices had achieved >90% adherence in the presence of a coach, compared with only 7 of 39 practices during the first month. Key behaviors with the greatest improvement included explanation of danger signs, temperature measurement, assessment of fetal heart sounds, initiation of skin-to-skin contact, and breastfeeding. Without a coach present, birth attendants' average adherence to practices and checklist use was 24 percentage points lower than when a coach was present (range: -1% to 62%). CONCLUSION: Implementation of the WHO Safe Childbirth Checklist with coaching improved uptake of and adherence to essential birth practices. Coordination and communication among facility staff, as well as behaviors with an immediate, tangible benefit, showed the greatest improvement. Difficult-to-perform behaviors and those with delayed or theoretical benefits were less likely to be sustained without a coach present. Coaching may be an important component in implementing the Safe Childbirth Checklist at scale.Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth intervention were pending publication in another journal. After the impact findings have been published, we will update this article on the effect of the intervention on birth practices with a reference to the impact findings

Pulmonary function measures predict mortality differently in IPF versus combined pulmonary fibrosis and emphysema

The composite physiologic index (CPI) was derived to represent the extent of fibrosis on high-resolution computed tomography (HRCT), adjusting for emphysema in patients with idiopathic pulmonary fibrosis (IPF). We hypothesised that longitudinal change in CPI would better predict mortality than forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (DLCO) in all patients with IPF, and especially in those with combined pulmonary fibrosis and emphysema (CPFE). Cox proportional hazard models were performed on pulmonary function data from IPF patients at baseline (n=321), 6 months (n=211) and 12 months (n=144). Presence of CPFE was determined by HRCT. A five-point increase in CPI over 12 months predicted subsequent mortality (HR 2.1, p=0.004). At 12 months, a 10% relative decline in FVC, a 15% relative decline in DLCO or an absolute increase in CPI of five points all discriminated median survival by 2.1 to 2.2 yrs versus patients with lesser change. Half our cohort had CPFE. In patients with moderate/severe emphysema, only a 10% decline in FEV1 predicted mortality (HR 3.7, p=0.046). In IPF, a five-point increase in CPI over 12 months predicts mortality similarly to relative declines of 10% in FVC or 15% in DLCO. For CPFE patients, change in FEV1 was the best predictor of mortality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91949/1/2011 ERJ - Pulmonary function measures predict mortality differently in IPF versus combined pulmonary fibrosis and emphysema.pd

Development of nutrition screening guideline content for use by healthcare staffs in older adults in health clinic setting: a scoping review

Introduction: Malnutrition, specifically undernutrition, in community-dwelling older adults reduces their well-being and predisposes to diseases. Therefore, timely malnutrition identification through nutrition screening is needed to identify at risk and malnourished patients. This study aimed to develop the content of nutrition screening guideline to facilitate healthcare staffs in health clinics to administer a validated nutrition screening tool specifically for older adults. Methods: A scoping review was conducted electronically using SCOPUS, PubMed, ProQuest Health & Medical Complete, and Cochrane databases. The systematic search was performed up to 31st December 2021. Search terms were created for identification of eligible and related articles. Inclusion and exclusion criteria were determined for the systematic search. The search was limited to English and Malay languages, and full text articles with no limitation of years. All data were extracted and analysed, guided by the PRISMA extension for scoping reviews (PRISMA-ScR). Results: From 728 identified articles, 18 articles were included in the analysis. Identified information for the guideline content were: introduction, aims and objectives, definition of malnutrition, prevalence of malnutrition, implementation of nutrition screening, guidance on administering items in validated tools, and guidance on anthropometric measurements. Meanwhile, format and flow charts from established guidelines served as references for the guideline development process. Conclusion: Appropriate content to develop a nutrition screening guideline has been identified based on this review. Development of a guideline based on this content can facilitate healthcare staffs to perform timely nutrition screening in older adults. Key words: healthcare staffs, malnutrition, nutrition screening guideline, older adults, scoping revie