Comparison of access to medicines between Klang Valley and East Coast of peninsular Malaysia for children living in poor households

Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia. Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children. Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal. Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.

Analgesic synergism of gabapentin and carbamazepine in rat model of diabetic neuropathic pain

Purpose: To evaluate synergy in the analgesic effects of a combination therapy of carbamazepine (CBZ) and gabapentin (GBP) in diabetic neuropathic pain. Methods: Neuropathic pain was produced in rats by a single intraperitoneal injection of streptozotocin (STZ) at 60 mg/kg. CBZ, GBP, and their combination were orally administered at varying doses (GBP 30 - 180 mg/kg; CBZ 20 - 40 mg/kg) comparable to their therapeutic doses in humans. Nociceptive responses in the diabetic rats were assessed using hot plate test. Results: Hot plate latency significantly increased with oral administration of GBP at a dose of 180 mg/kg when compared with control group (p < 0.05), while at a dose of 90 mg/kg, the increase was not significant. Oral administration of CBZ at doses of 20 and 40 mg/kg did not produce any significant impact on hot plate latency. However, a combination of GBP at 90 mg/kg and CBZ at 20 mg/kg produced significant increase in latency, compared with control group and other groups (p < 0.05), except the group that received 180 mg/kg GBP. The combination of low dose GBP 30 mg/kg and carbamazepine 30 mg/kg had no significant effect on latency (p > 0.05). Conclusion: The results obtained in this study provide useful information on the combination therapy of GBP and CBZ, which may be applied in the treatment of pain in diabetic neuropathy.

Factors associated with hypoglycemia episodes in hospitalized type 2 diabetes mellitus patients in a tertiary health facility in Malaysia

Purpose: To determine the factors associated with severity of hypoglycemia in hospitalized type 2 diabetes mellitus patients in a tertiary health facility in Malaysia. Methods: This retrospective study involved 207 hospitalised T2DM patients with hypoglycaemia episodes from January 2008 to December 2012 and was conducted in University Malaya Medical Centre, Petaling Jaya, Malaysia. Patients were classified into 2 groups, viz, those who had hypoglycaemia on admission and those who had hypoglycaemia during hospital stay. Patients with hypoglycemia on admission were those admitted due to hypoglycemia while patients with hypoglycemia during hospital stay were those admitted due to other causes but subsequently developed hypoglycemia during hospitalization. Results: The results for the 207 patients investigated show that most of the patients (72.2 %) were asymptomatic during hypoglycemic episodes. The majority of the episodes (57.4 %) experienced by the patients were mild hypoglycemia (< 3.9 mmol/L). Old age (p = 0.011) and presence of stroke (p = 0.033) were found to be significantly associated with severe hypoglycemia (< 2.2 mmol/L) while concurrent use of opioid (p = 0.008) was associated with mild hypoglycemia. Conclusion: The identification of the underlying factors associated with severity of hypoglycemia may help in preventing and resolving hypoglycemia in T2DM patients.

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A prospective, observational study was conducted with the objectives of identifying the degree of malnutrition, complications and the need for nutritional support in elective surgical patients. Collection of data was performed in local tertiary hospitals using a Patient Generated Subjective Global Assessment (PG - SGA) nutritional screening tool and medical records. Results: A total of 50 patients electively admitted for surgery were included. The results demonstrated that there was a significant increase in malnourished patients post-surgery compared to pre-surgery (p = 0.0001). Most interesting was the significant number of complications observed post-surgery compared to pre-surgery (p = 0.035) which was associated to the poor level of nutrition. The most common type of complications noted post-surgery were nosocomial infection, wound infection and readmission. Conclusion: Malnutrition is prevalent pre- and post-operatively in Malaysia. Therefore, focus on the outcome of these malnourished patients should be performed to reduce complications associated with poor nutrition.

Proteomic profile of acute myeloid leukaemia: A review update

Proteome analysis is a complex and dynamic process that encompasses several analytical platforms that include protein sequencing, structural or expression proteomics, protein modification, sub-cellular protein localization, protein-protein interaction and biological functional proteomics. In fact, expression proteomics is extensively applied in a majority of biomarker detection studies because it provides a detailed overview of differentially expressed proteins in cellular pathways and disease processes. Proteomics are also effective and dynamic in protein-protein interactions and cross-talks between interacting molecules of the cell. Proteomics has evolved into a crucial tool used to investigate the biochemical changes that possibly lead to development of cancer biomarkers. This review draws attention to the progress and advancements in cancer proteomics technology with the aim of simplifying the understanding of the mechanisms underlying the disease and to contribute to detection of biomarkers in addition to the development of novel treatments. Given that proteome is a dynamic entity of cellular functions in health and disease, it is capable of reflecting the immediate environmental state of cells and tissues as shown in this review. The review shows the possibility of elucidating the pathophysiology of acute myeloid leukaemia (AML) through proteome expressions, thus confirming the viability of proteome analysis in profiling AML.

Layered workflow scheduling algorithm

Workflow applications require workflow processing in which workflow tasks are processed based on their dependencies. With the emergency of complex distributed systems such as grids and clouds, efficient workflow scheduling (WFS) algorithms have become the core components of the workflow management systems (WfMS). Thus, WFS that allocates each task in the workflow to a relevant resource with the aim of improving system performance and end user satisfaction is fundamentally important. In this paper, we propose a new workflow scheduling algorithm called Layered Workflow Scheduling Algorithm (LWFS) for scheduling workflow applications. We studied the efficacy of the LWFS scheduling experimentally and compared its performance with approaches including Improved Critical Path using Descendant Prediction (ICPDP), Highest Level First with Estimated Time (HLFET), Modified Critical Path (MCP) and Earliest Time First (ETF). The results of the experiments show that the proposed approach outperforms other approaches.

Prognostic value of fat mass and skeletal muscle mass determined by computed tomography in patients who underwent transcatheter aortic valve implantation

Body composition (fat mass [FM] and skeletal muscle mass [SMM]) predicts clinical outcomes. In particular, loss of SMM (sarcopenia) is associated with frailty and mortality. There are no data on the prevalence and impact of FM and SMM in patients undergoing transcatheter aortic valve implantation (TAVI). The objective of this study is to determine body composition from pre-TAVI computed tomography (CT) and evaluate its association with clinical outcomes in patients who underwent TAVI. A total of 460 patients (mean age 81 ± 8 years, men: 51%) were included. Pre-TAVI CTs of the aorto-ilio-femoral axis were analyzed for FM and SMM cross-sectional area at the level of the third lumbar vertebrae (L3). Regression equations correlating cross-sectional area at L3 to total body FM and SMM were used to determine prevalence of sarcopenia, obesity, and sarcopenic obesity in patients (64%, 65%, and 46%, respectively). Most TAVI procedures were performed through a transfemoral approach (59%) using a balloon-expandable valve (94%). The 30-day and mid-term (median 12 months [interquartile range 6 to 27]) mortality rates were 6.1% and 29.6%, respectively. FM had no association with clinical outcomes, but sarcopenia predicted cumulative mortality (hazard ratio 1.55, 95% confidence interval 1.02 to 2.36, p = 0.04). In conclusion, body composition analysis from pre-TAVI CT is feasible. Sarcopenia, obesity, and sarcopenic obesity are prevalent in the TAVI population, with sarcopenia predictive of cumulative mortality.

Workflow scheduling on distributed systems

Growing evidence shows that in obtaining high performance, a well-managed time-constrained workflow scheduling is needed. Efficient workflow scheduling is critical for achieving high performance especially in heterogeneous computing system. However, it is a great challenge to improve performance and to optimize several objectives simultaneously. We propose a workflow scheduling algorithm that minimizes the makespan of the workflow application modeled by a Directed Acyclic Graph (DAG). The new proposed scheduling algorithm is named Multi Dependency Joint (MDJ) Algorithm. The performance of MDJ is compared with existing algorithms such as, Highest Level First with Estimated Time (HLFET), Modified Critical Path (MCP) and Earliest Time First (ETF). As a result, the experiments show that our proposed MDJ algorithm outperforms HLEFT, MCP, and EFT with a 7% lower overall completion time.

New artificial intelligence based tire size identification for fast and safe inflating cycle

Motor vehicle accidents are one of the main killers on the road. Modern vehicles have several safety features to improve the stability and controllability. The tire condition is critical to the proper function of the designed safety features. Under or over inflated tires adversely affects the stability of vehicles. It is generally the vehicle's user responsibility to ensure the tire inflation pressure is set and maintained to the required value using a tire inflator. In the tire inflator operation, the vehicle's user sets the desired value and the machine has to complete the task. During the inflation process, the pressure sensor does not read instantaneous static pressure to ensure the target value is reached. Hence, the inflator is designed to stop repetitively for pressure reading and avoid over inflation. This makes the inflation process slow, especially for large tires. This paper presents a novel approach using artificial neural network based technique to identify the tire size. Once the tire size is correctly identified, an optimized inflation cycle can be computed to improve performance, speed and accuracy of the inflation process. The developed neural network model was successfully simulated and tested for predicting tire size from the given sets of input parameters. The test results are analyzed and discussed in this paper.

Optimal sensing requirement for slippage prevention in robotic grasping

This paper presents a new theoretical development and modelling related to the requirement of the minimum number of sensors necessary for slippage prevention in robotic grasping. A fundamental experimental investigation has been conducted to support the newly developed postulate. A series of basic experiments proved that it is possible to evaluate the contributions of various sensors to slippage prevention and control in robotic grasping. The use of three discrete physical sensors, one for each of the three sensing functions (normal, tangential and slippage), has been proven to be the most reliable combination for slippage prevention in robotic grasping. It was also proven that the best performance from a two-sensor combination can be achieved when normal grasp force and tangential force are both monitored in the grasping process.

Addition of biological functionality to poly(epsilon-caprolactone) films

Biodegradable polyesters such as poly(epsilon-caprolactone) (PCL) have a number of biomedical applications; however, their usage is often limited by a lack of biological functionality. In this paper, a PCL-based polymer containing pendent groups activated by 4-nitrophenyl chloroformate (NPC) and reactive toward primary amines has been cast into thin films. The reactivity of the films toward poly(l-lysine) and the cell adhesion peptide, GRGDS, was assessed, and their cell adhesive capabilities were characterized. ATR-FTIR analysis found that NPC functional groups were present on the surface of the cast film, and the synthesis, conjugation, and visualization of a fluorescent molecule on these films further demonstrated the success of this functionalization methodology. The immersion of these films into a solution of either poly(l-lysine) (PLL) or GRGDS in PBS (pH 7.4) and subsequent 3T3 fibroblast adhesion studies demonstrated significant improvement in cell adhesion and spreading over films cast from unmodified PCL. This investigation has shown that this novel NPC-containing polymer can be utilized in many applications where increased cellular adhesion is required, or the coupling of specific molecules to polymer surfaces is of interest.

IncSPADE: an incremental sequential pattern mining algorithm based on SPADE property

In this paper we propose Incremental Sequential PAttern Discovery using Equivalence classes (IncSPADE) algorithm to mine the dynamic database without the requirement of re-scanning the database again. In order to evaluate this algorithm, we conducted the experiments against three different artificial datasets. The result shows that IncSPADE outperformed the benchmarked algorithm called SPADE up to 20%.

Aerobic fermentation of saccharomeyes cerevisae in a miniature bioreactor made of low cost poly(methylmethacrylate) (PMMA) and poly(Dimethylsiloxane) (PDMS) polymers

In this paper, a minibioreactor platform made of low cost polymers is presented. The minibioreactor prototype was designed as an alternative solution for carrying out microbial fermentation experiments in laboratory. The minibioreactor prototype has a working volume of 1.5 mL and was fabricated from poly(methylmethacrylate) (PMMA) and poly(dimethylsiloxane) (PDMS) polymers. Cell density was measured online whilst agitation rates and the temperature of the reactor content can be tightly controlled to desired set-point values. As proof-of-concept, various S. cerevisae fermentation experiments were conducted. In every experiment, the minibioreactor operated stably for the entire length of operation which was nearly 40 h with very minimal volume loss i.e. about 2.8 μ·h-1 at 37°C. The minibioreactor has the maximum oxygen transfer rate (OTR) of 16.6 mmol·L-1·h-1 under the agitation rate of 300 rpm. Under these conditions, cell specific growth rate as high as 0.291 h-1 was obtained. The experimental data in the minibioreactor operation was also reproducible using shake flask where similar growth profiles were attained under a similar growth conditions.

Phytochemical analysis of Hibiscus caesius using high performance liquid chromatography coupled with mass spectrometry

Various species in genus Hibiscus are traditionally known for their therapeutic attributes. The present study focused on the phytochemical analysis of a rather unexplored species Hibiscus caesius (H. caesius), using high-pressure liquid chromatography coupled with mass spectrometry (HPLC-MS). The analysis revealed five major compounds in the aqueous extract, viz. vanillic acid, protocatechoic acid, quercetin, quercetin glucoside and apigenin, being reported for the first time in H. caesius. Literature suggests that these compounds have important pharmacological traits such as anti-cancer, anti-inflammatory, anti-bacterial and hepatoprotective etc. however, this requires further pharmacological investigations at in vitro and in vivo scale. The above study concluded the medicinal potential of H. caesius.

Evaluation of glucose dehydrogenase and pyrroloquinoline quinine (pqq) mutagenesis that renders functional inadequacies in host plants

The rhizospheric zone abutting plant roots usually clutches a wealth of microbes. In the recent past, enormous genetic resources have been excavated with potential applications in host plant interaction and ancillary aspects. Two Pseudomonas strains were isolated and identified through 16S rRNA and rpoD sequence analyses as P. fluorescens QAU67 and P. putida QAU90. Initial biochemical characterization and their root-colonizing traits indicated their potential role in plant growth promotion. Such aerobic systems, involved in gluconic acid production and phosphate solubilization, essentially require the pyrroloquinoline quinine (PQQ)- dependent glucose dehydrogenase (GDH) in the genome. The PCR screening and amplification of GDH and PQQ and subsequent induction of mutagenesis characterized their possible role as antioxidants as well as in growth promotion, as probed in vitro in lettuce and in vivo in rice, bean, and tomato plants. The results showed significant differences (p ≤ 0.05) in parameters of plant height, fresh weight, and dry weight, etc., deciphering a clear and in fact complementary role of GDH and PQQ in plant growth promotion. Our study not only provides direct evidence of the in vivo role of GDH and PQQ in host plants but also reveals their functional inadequacy in the event of mutation at either of these loci.