Spatial inequalities in Malaysia’s non-revenue water rates issues, challenges and management strategies

In Malaysia, high non-revenue water (NRW) rate is amongst the country’s top water issues. NRW rates of all states in the country vary greatly, with the rates ranging from 18.2 to 62.4 per cent. This huge spatial variation is due to variations in management efficiency of the water operator, amount of funding for NRW reduction programme and level of public awareness. This paper aims to examine the effect of the spatial inequality on NRW management in Malaysia’s states by comparing NRW rates between states with different area sizes. The study is mainly based on literature review and secondary data. The results show that states with smaller surface areas recorded lower NRW rates but the smallest state was found to record the highest NRW rate. Factors such as service’s coverage area, population density, water supply network density, dispersal of the city area, and location of the water users, and type of water users also have significant impacts on NRW management. For example, high water supply network density, poor water resources availability and high demand in Penang have forced the state’s water operator to increase its efficiency in NRW management. In contrast, low water demand, low population density, and less commercial area in Perlis are found to be the reasons of high NRW rate in the state. In conclusion, spatial factors can impact NRW as smaller states can better manage NRW due to the smaller water service areas covered. However, states cannot use size of service area and spatial variations as excuses for high NRW as the study found that adequate funding, proper planning, effective management, efficient service, and proactive strategies of water operator are more important factors that can have significant impacts on the NRW rates

Understanding Public Perception of and Participation in Non-Revenue Water Management in Malaysia to Support Urban Water Policy

In contextualising the serious water loss, inefficient resource utilization, and ineffective water utility management in Malaysia, the objective of this study is to understand the public’s perception of non-revenue water (NRW) management in order to provide policy inputs, and to determine ways to improve public participation in NRW reduction. Findings reveal that there is currently only meagre public participation in NRW management in Malaysia, with a majority of the respondents demonstrating a lack of knowledge and awareness on NRW; over-dependence on water utility and government agencies in reducing NRW rates; and failure to submit a report when a leaking pipe is noticed. Educating the public on the importance of reducing NRW and promoting public interests and concerns around water tariffs, is essential to improve NRWreductions in Malaysia. Community-led strategies to better engage the public in addressing NRW-related issues have to be enhanced. To this end, concrete policy implications derived from the findings of the study are outlined

A Critical Evaluation of River Management Models in Malaysia

Rivers are important natural resources of a country as they provide a wide range of ecosystem services. However, the problem is that rivers in Malaysia are badly degraded due to mismanagement, neglect, pollution and abuse. River management in Malaysia is largely based on the government-centric top-down model which is sectoral-based. This model is ineffective as it has no private sector, NGO and public engagement and support. This paper aims to examine various types of river management models to identify the ones that can be effective in Malaysia. The methodology used a mixture of literature review of existing river management models, secondary data on published journal papers, reports and books on river management. Results of selected river management conferences are also studied, examined and findings synthesized. Primary data is also compiled with selected in-depth qualitative interviews with key government officers, managers of private companies, NGO officers and village heads. Results show that the government (various levels) is traditionally the responsible party in managing rivers, but increasingly, the public, NGOs, businesses and other stakeholders are actively involved. Results also show that holistic river management with active engagement of all stakeholders is necessary. In Malaysia, rivers are found to be intricately intertwined with all aspects of development. It was concluded that the Public-Private Partnership (PPP) model is an effective river management model in Malaysia as it conserves the river and its environment, and brings together all parties for building their capacities in river management towards achieving many Sustainable Development Goals (SDGs)

Abundant copy-number loss of CYCLOPS and STOP genes in gastric adenocarcinoma

Background Gastric cancer, a leading cause of cancer death worldwide, has been little studied compared with other cancers that impose similar health burdens. Our goal is to assess genomic copy-number loss and the possible functional consequences and therapeutic implications thereof across a large series of gastric adenocarcinomas. Methods We used high-density single-nucleotide polymorphism microarrays to determine patterns of copy-number loss and allelic imbalance in 74 gastric adenocarcinomas. We investigated whether suppressor of tumorigenesis and/or proliferation (STOP) genes are associated with genomic copy-number loss. We also analyzed the extent to which copy-number loss affects Copy-number alterations Yielding Cancer Liabilities Owing to Partial losS (CYCLOPS) genes–genes that may be attractive targets for therapeutic inhibition when partially deleted. Results The proportion of the genome subject to copy-number loss varies considerably from tumor to tumor, with a median of 5.5 %, and a mean of 12 % (range 0–58.5 %). On average, 91 STOP genes were subject to copy-number loss per tumor (median 35, range 0–452), and STOP genes tended to have lower copy-number compared with the rest of the genes. Furthermore, on average, 1.6 CYCLOPS genes per tumor were both subject to copy-number loss and downregulated, and 51.4 % of the tumors had at least one such gene. Conclusions The enrichment of STOP genes in regions of copy-number loss indicates that their deletion may contribute to gastric carcinogenesis. Furthermore, the presence of several deleted and downregulated CYCLOPS genes in some tumors suggests potential therapeutic targets in these tumors.Singapore. Ministry of Health (Duke-NUS Signature Research Programs)Singapore. Agency for Science, Technology and ResearchSingapore-MIT Allianc

Inhibition of Enterovirus 71 (EV-71) Infections by a Novel Antiviral Peptide Derived from EV-71 Capsid Protein VP1

Enterovirus 71 (EV-71) is the main causative agent of hand, foot and mouth disease (HFMD). In recent years, EV-71 infections were reported to cause high fatalities and severe neurological complications in Asia. Currently, no effective antiviral or vaccine is available to treat or prevent EV-71 infection. In this study, we have discovered a synthetic peptide which could be developed as a potential antiviral for inhibition of EV-71. Ninety five synthetic peptides (15-mers) overlapping the entire EV-71 capsid protein, VP1, were chemically synthesized and tested for antiviral properties against EV-71 in human Rhabdomyosarcoma (RD) cells. One peptide, SP40, was found to significantly reduce cytopathic effects of all representative EV-71 strains from genotypes A, B and C tested, with IC50 values ranging from 6–9.3 µM in RD cells. The in vitro inhibitory effect of SP40 exhibited a dose dependent concentration corresponding to a decrease in infectious viral particles, total viral RNA and the levels of VP1 protein. The antiviral activity of SP40 peptide was not restricted to a specific cell line as inhibition of EV-71 was observed in RD, HeLa, HT-29 and Vero cells. Besides inhibition of EV-71, it also had antiviral activities against CV-A16 and poliovirus type 1 in cell culture. Mechanism of action studies suggested that the SP40 peptide was not virucidal but was able to block viral attachment to the RD cells. Substitutions of arginine and lysine residues with alanine in the SP40 peptide at positions R3A, R4A, K5A and R13A were found to significantly decrease antiviral activities, implying the importance of positively charged amino acids for the antiviral activities. The data demonstrated the potential and feasibility of SP40 as a broad spectrum antiviral agent against EV-71

Oncogenic Pathway Combinations Predict Clinical Prognosis in Gastric Cancer

Many solid cancers are known to exhibit a high degree of heterogeneity in their deregulation of different oncogenic pathways. We sought to identify major oncogenic pathways in gastric cancer (GC) with significant relationships to patient survival. Using gene expression signatures, we devised an in silico strategy to map patterns of oncogenic pathway activation in 301 primary gastric cancers, the second highest cause of global cancer mortality. We identified three oncogenic pathways (proliferation/stem cell, NF-κB, and Wnt/β-catenin) deregulated in the majority (>70%) of gastric cancers. We functionally validated these pathway predictions in a panel of gastric cancer cell lines. Patient stratification by oncogenic pathway combinations showed reproducible and significant survival differences in multiple cohorts, suggesting that pathway interactions may play an important role in influencing disease behavior. Individual GCs can be successfully taxonomized by oncogenic pathway activity into biologically and clinically relevant subgroups. Predicting pathway activity by expression signatures thus permits the study of multiple cancer-related pathways interacting simultaneously in primary cancers, at a scale not currently achievable by other platforms

Data-Driven Analysis of COVID-19 Reveals Persistent Immune Abnormalities in Convalescent Severe Individuals

Severe SARS-CoV-2 infection can trigger uncontrolled innate and adaptive immune responses, which are commonly associated with lymphopenia and increased neutrophil counts. However, whether the immune abnormalities observed in mild to severely infected patients persist into convalescence remains unclear. Herein, comparisons were drawn between the immune responses of COVID-19 infected and convalescent adults. Strikingly, survivors of severe COVID-19 had decreased proportions of NKT and Vδ2 T cells, and increased proportions of low-density neutrophils, IgA+/CD86+/CD123+ non-classical monocytes and hyperactivated HLADR+CD38+ CD8+ T cells, and elevated levels of pro-inflammatory cytokines such as hepatocyte growth factor and vascular endothelial growth factor A, long after virus clearance. Our study suggests potential immune correlates of “long COVID-19”, and defines key cells and cytokines that delineate true and quasi-convalescent states

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake