Introduction: Coated archwires improve aesthetics because of the tooth-coloured appearance. However, colour change of the coated archwires have been reported in vitro. Nonetheless, little is known to what extent this colour change occurs clinically. This second part of the multi-centre, double-blind, randomised controlled trial evaluated the colour change (∆E*) of three coated archwires with their controls and patient perception. Methods: 84 patients who received treatment with upper and lower fixed appliance treatment were invited. Consented patients were randomised to receive one of four treatment interventions using 0.014” superelastic nickel-titanium archwires from (1) Orthocare (2) RMO (3) G&H, and (4) 3M Unitek® uncoated. These archwires were ligated during bonding and collected after 8th week. After removal, the digital images of the archwires were assessed for colour change using Adobe® Photoshop® software, and the CIE L*a*b* system was used to calculate the ΔE* values. Patient perception was measured using oral aesthetic subjective impact scale (OASIS) questionnaire. Results: For colour change and patient perception assessment, 132 archwires from 66 participants who had been treated with aesthetic archwires were collected. Two fractured archwires were excluded. Initial analysis revealed all three aesthetic archwires groups showed significant mean of ∆E* with the highest was found in Orthocare (23.9), and the lowest is G&H (16.8). Post hoc comparison revealed statistically significant mean of ∆E* in Orthocare when compared with other groups (p <0.001). There was no statistically significant difference for patient perception between archwire groups. Conclusion: Preliminary results revealed that significant ∆E* in Orthocare group and patients showed positive perception following clinical use
Craniofacial & ; Biomaterial Sciences Cluster, Advanced Medical & ; Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia. 2 School of Dental Sciences, Universiti Sains Malaysia (Health Campus), 16150 Kubang Kerian, Kelantan, Malaysia

Chrysanthemum rubellum (durian) flower (CR) is well-known for its usefulness in conventional and advanced medicine. Bioactive glass properties are geared towards hard tissue regeneration. Hence, this study aims to investigate the response of dental pulp stem cells (DPSC) when exposed to bioactive glass-chrysanthemum flower extract-conditioned medium. Methods: Chrysanthemum rubellum (durian) yellow coloured petals freeze dried extracts (CRE) was prepared by separation and agitation in distilled water where the final powdery compound was being investigated and combined with melt-derived BG 45S5 powder to produce BGCRE-conditioned medium. The CRE extracts in various concentrations and BGCRE-conditioned medium were exposed to DPSC and the cells responses were assessed using AB and MTT assays. The CRE and BGCRE-conditioned media were also assessed using ICP-OES to check for ionic release profile from both medium. Results: The CRE-conditioned medium (7.81, 15.63, 31.25 and 62.5 μg/ml) showed a dose-dependent effect towards DPSC from Days 1 until 14. The BGCRE-conditioned medium containing BG powders (1 mg/ml) with the lower amount of CRE extracts (0.02 and 0.1 mg/ml) promoted DPSC viability and proliferation rate from Days 1 until 14 based on AB and MTT assays. The BGCRE-conditioned medium has potentially affected the DPSC viability and proliferation. Conclusion: The presence of CRE in BGCRE-conditioned medium enhanced the DPSC viability and proliferation possibly through the combined effect of CRE and BG. This BGCRE combination showed potential as natural medicament for dental tissue regeneration
Craniofacial and Biomaterials Sciences Cluster ; Advanced Medical & ; Dental Institute ; Universiti Sains Malaysia ; Bertam ; 13200 Kepala Batas ; Pulau Pinang ; Malaysia 2 Department of Paedodontics and Preventive Dentistry ; Coorg Institute of Dental Sciences ; Virajpet ; 571218 ; Coorg Institute ; Karnataka State ; India 3 Faculty of Applied Sciences ; Universiti Teknologi MARA ; 40450 Shah Alam ; Selangor ; Malaysia

The National Blood Center, Kuala Lumpur interprets laboratory results for the von Willebrand factor (VWF) profile based on guidelines which were established based on the Caucasian population. The VWF profiles among the Malay population has not yet been established. The current study aims to determine the VWF profiles of the different ABO blood types among Malays and to evaluate their association with demographic characteristics and smoking habits. Methods: One hundred and forty Malay donors were involved. Factor VIII (FVIII:C), VWF antigen (VWF:Ag), and ristocetin cofactor (VWF:RiCof) levels and collagen binding activity (VWF:CBA) were measured by coagulometric clot detection, latex agglutination, and enzyme-linked immunosorbent assay. Results: The majority of donors (59.3%) were 30–49 years old, male (81.43%), non-smokers (74.3%), and overweight (71.4%). The Malay VWF:Ag were slightly higher than those of Caucasians, Indians, Thais, and Chinese, but the average ratios of VWF activity (i.e., VWF:RiCof level and VWF:CBA) to VWF:Ag were slightly lower than those of the other populations. The highest level of VWF:Ag was found among those with the B blood group, followed by types A and O. Conclusion: Malays with type O blood had lower values of the components of the VWF profile compared to subjects with non-O blood. The higher levels of these elements and lower VWF activity to VWF:Ag ratio in Malays compared to other populations suggest that ethnicity impacts the plasma VWF levels and their interaction with collagen and platelets.
Medical Transfusion Unit, Pathology Department, Hospital Sultan Ismail, Johor Bahru, Malaysia. 2 National Blood Center, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia. 3 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia

Breast cancer is globally known to be the commonest cause of cancer-related deaths among women. Screening tools which include breast-self examination (BSE), clinical breast examination and mammography are well-recognised to aid the detection of breast cancer among high risk women. Thus, our study was aimed to evaluate breast cancer and BSE awareness and practice, and to perform mammography screening among women who attended community breast cancer awareness and screening programme. Methods: Data was collected cross-sectionally from 2,021 women during community services from September 2013 until December 2015. Results: Majority of the women had previously attended health education on breast cancer (56.3%) and had been taught BSE techniques (61.4%), but only 38.6% performed BSE monthly. Factors associated with regular BSE practice were older age, higher education level, being married, higher monthly income, had attended health education on breast cancer, and had been taught BSE techniques. A subset of 130 high-risk women had underwent mammography screening and majority had heterogenously dense and normal mammogram findings. Conclusion: These findings suggested that regular breast cancer awareness campaigns is needed to strengthen breast cancer knowledge and to emphasise BSE techniques. Such campaigns should target younger women and those with low socioeconomic status.
Regenerative Medicine Cluster, Advanced Medical & ; Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang, Malaysia. 2 Clinical Division, Advanced Medical & ; Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang, Malaysia

Thalassemia prevalence in Malaysia is highest in Sabah. This study was conducted to characterize the demographic and socioeconomic profile of transfusion-dependent β-thalassemia major patients in Sabah, to explore their parents’ background, and to identify factors associated with having more than one thalassemia major children in the family. Methods: This was a cross-sectional study conducted in Hospital Wanita dan Kanak-Kanak Sabah and Hospital Kota Belud Sabah between February 2018 and Jun 2019. A total of 108 patients attending Thalassemia Treatment Clinic at both centers were selected randomly for interview. Results: β-thalassemia major patients in this study were majority from the indigenous ethnic groups (Kadazan, Dusun, Murut, Rungus, Sungai). Parents of the thalassemia patients mostly had low education level and socioeconomic status. Thirty-seven percent of parents have more than one children with thalassemia major and a high proportion (41.7%) have intermarriages. Parents with a higher number of children in the family are associated with having more than one thalassemia major children (OR: 2.1, 95% CI: 1.5, 2.9, P-value = 1.3 x 10-5). Conclusions: A considerably high proportion of parents have more than one children with thalassemia major in this study. Knowledge and counselling are important to parents with low educational level and socioeconomic status to ensure their understanding of thalassemia risk and prevention
Hospital Queen Elizabeth II, Ministry of Health Malaysia, 88300, Kota Kinabalu, Sabah, Malaysia 2 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang, Malaysia 3 Hospital Wanita dan Kanak-Kanak Kuala Lumpur, Ministry of Health Malaysia, 50586, Kuala Lumpur, Malaysia 4 Hospital Wanita dan Kanak-Kanak Sabah, Ministry of Health Malaysia, 88996, Kota Kinabalu, Sabah, Malaysia 5 Hospital Kota Belud, Ministry of Health Malaysia, 89158, Kota Belud, Sabah, Malaysia

Colour stability of the material is an essential factor that contributes to the selection of a flexible denture material. Staining effects on the denture may result in unattractive appearance, the dissatisfaction of the wearer, and limited usage period of the denture. This study aims to identify the colour stability of the Valplast flexible denture material using three types of beverages. Methods: A total of 32 disc-shaped flexible resin materials (20 +/- 0.1 mm in diameter and thickness 3 +/- 0.1 mm) were prepared based on the manufacturer instructions. The samples were randomly divided into 4 groups of immersion: distilled water (control), coffee solution, tea solution and red wine. The samples were left in the specified immersion solution for up to 60 days. Colour changes were measured after 1, 3, 7, 14, 21, 30, 45 and 60 days of immersion. Results: The samples immersed in coffee solution changed from S1 to S2, whereas samples in tea solution changed from S1 to S3. Additionally, samples in red wine changed from S1 to S4, as observed using the Valplast colour tone guide. The highest reflection measured using spectroscopy was 65.146 at 385.19 nm of the control samples, whereas the lowest reflection was 1.974 at the wavelength of 385.97 nm on the samples immersed in the red wine. Conclusion: The most significant difference can be observed in the red wine group, followed by samples in tea and coffee solutions. Moreover, increasing the immersion period causes increasing staining effect of the denture.
Craniofacial and Biomaterial Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Bertam, Penang, Malaysia 2 Institut Latihan Kementerian Kesihatan Malaysia (Pergigian), No.3 Jalan Sepoy Lines, 10450 Georgetown, Penang, Malaysia 3 Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Bertam, Penang, Malaysia 4 School of Physics, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia

Introduction: Nasopharyngeal cancer is known to be a rare malignancy that effects the head and neck region involving the nasopharynx. It has a 0.8% occurrence rate among all types of cancer and has many risk factors ranging from viral infections to dietary intake habits. This study aims in determining the geographical variations across the world and its associated risk factors with nasopharyngeal cancer. Methods: The study was initiated by extracting relevant literature articles from electronic databases such as PubMed, Science Direct and SEER from 2008-2018. Search strategy also included key terms; nasopharyngeal cancer, nasopharyngeal carcinoma, prevalence, risk factors, geographic variation, distribution, incidences, epidemiology and mortality. Results: Nasopharyngeal cancer is most common in Asia and China had the most number of new cases diagnosed in 2018. The standard incidence rate of nasopharyngeal cancer globally in 2018 was 1.5 per 100,000. The standardized mortality rate for nasopharyngeal cancer globally in 2018 was 0.84 per 100,000. The 5 identified countries with the highest mortality rates were China, Indonesia, Vietnam, India and Philippines accordingly. Among the risk factors attributing to the incidences of nasopharyngeal cancer are Epstein Barr Virus (EBV) infection, salted and preserved food consumption and tobacco smoking. Conclusion: Nasopharyngeal cancer is strongly associated with the variation of geographical regions therefore adequate knowledge, early detection, immediate administration of treatment and rapid detection is vital in reducing the global incidence burden.

Introduction: CRISPR/Cas9 nuclease has gained popularity as a genome editing tool due to its straight-forward mechanism. However, there are concerns that CRISPR nuclease would cause off-target and toxicity. The CRISPR/ Cas9 D10A nickase was designed to enhance genome editing. Nevertheless, this raised the question of whether the efficiency of nickase is compromised compared to CRISPR/Cas9 nuclease. Targeting HIV genes, we investigated if CRISPR nuclease performed better than the nickase in efficacy and safety. Methods: CRISPR nucleases and nickases were designed to target Gag, Pol, Rev, Vif, Tat and LTR. HIV latently infected cell line, ACH-2, was transfected with the nucleases and nickases. Changes to viral load after CRISPR treatment was measured using p24 ELISA. Safety of nuclease and nickase was monitored using GFP expression with fluorescence microscopy and flow cytometry. Targeting two sites within the same gene, and targeting multiple genes concurrently were also studied to determine efficacy of CRISPR in reducing viral load. Results: A 44.9 to 68.1% and a 34.4 to 49.7% decrease in viral load was seen in CRISPR nuclease and nickase respectively. Microscopy and flow cytometry results showed that the nickase system was slightly toxic with a 0.31 to 0.7-fold cell death. There was a 34% decrease in viral load when two sites were targeted within a gene, and the largest decrease was seen when all the nucleases were combined, giving a 75.4% decrease in viral load at day 5. Conclusion: The knowledge gained from this study will be employed to improve genome editing in other disease models.

Introduction: Transfusion Medicine is an evolving filed which integrates multidisciplinary science in providing safe blood and blood products for patients. With an increasing demand for Transfusion Medicine training in Malaysia, a formal survey is needed to evaluate the postgraduate Transfusion Medicine programme offered by Advanced Medical and Dental Institute, Universiti Sains Malaysia to identify areas of deficiency based on the alumni experiences. Methods: An English language survey form was developed specifically to assess the programme contents (overall contents, learning experience in each year, and support in research), the alumni perception on soft-skills gained during the study, and the outcome of the programme. The survey forms were distributed to all alumni between March 2018 and October 2018 via e-mail or hand-delivered. Results: The survey response rate was 79% (37 of 47). A majority (97%) of the transfusion medicine specialists (TMS) in this study reported that the course offered in the program was relevant to their current job. The learning experience which includes course content, student’s placement, facilities, and support in research) were rated between satisfactory and good. Communicating effectively through speaking was the highest reported soft-skill gained during the programme, whereas communicating effectively in writing was the lowest soft-skill gained. On the programme outcome, all TMS agreed that this programme will produce qualified and well trained specialists for current working market. Conclusion: Some improvement in the programme contents and teaching activities are needed to equip the future TMS for the nation.

Introduction: Exergames is defined as a technology-driven physical activity, which is an innovative way of physical activity that integrates interactive gameplay in the exercise process. The exergames may provide enjoyable experiences that could motivate people to participate and continue playing the game play, while also exercising at the same time. Methods: This article presents a treasure hunt-based walking exergames on android platform with the implementation of intelligence-based image recognition. The exergame, termed USM ExerHunt uses images of Universiti Sains Malaysia buildings as the hints. The participant of the game supposes to find a building shown in the hint, and once reaching the destination captures the image of the building. Then, the application will calculate the total steps taken and calories burnt by the participant using an implementation of accelerometer from the mobile phone. Results: The developed USM ExerHunt application is able to achieve accurate image recognition of USM building, with the accuracy rate of 92%. Besides that, the application is capable of calculating the number of total steps and calories burnt after an exercise routine is completed. Conclusion: This android application has shown a proof of concept in incorporating machine intelligence into an exergame application, with pilot study within the USM community.