Inadequate vitamin D intake among pregnant women in Malaysia based on revised recommended nutrient intakes value and potential dietary strategies to tackle the inadequacy

Siew Siew Lee,Raman Subramaniam,Maiza Tusimin,King Hwa Ling,Kartini Farah Rahim,Su Peng Loh 한국영양학회 2021 Nutrition Research and Practice Vol.15 No.4

BACKGROUND/OBJECTIVES: Recently, the recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1–70 yrs has been revised from 5 μg/day to 15 μg/day. This study is aimed to assess the adequacy of vitamin D intake based on revised RNI and to recommend several dietary strategies to increase total vitamin D intake. SUBJECTS/METHODS: Vitamin D intake from both food and supplement of 217 pregnant women was assessed using a validated food frequency questionnaire. Hypothetical effect of expanded supplementation and food fortifications strategies were modelled using the consumption data. RESULTS: The results revealed that more than half (67.7%) of pregnant women had inadequate vitamin D intake (RNI < 15 μg/day). The modelling results demonstrated the potential of universal provision of 10 μg/day of multivitamins supplements in increasing vitamin D intake. Moreover, mandatory fortification of both milk and malted drink at single level of 5 μg/serving would lead to increase in vitamin D intake of Malaysians, particularly pregnant women. CONCLUSIONS: The outcome of this study can be used as a reference for public health professionals to re-evaluate the existing Malaysian food fortification policies and supplementation recommendation for vitamin D for pregnant women.

Building a Sustainable Competitive Advantage for Multi-Level Marketing (MLM) Firms: An Empirical Investigation of Contributing Factors

Lee Siew Keong,Omkar Dastane 한국유통과학회 2019 유통과학연구 Vol.17 No.3

Purpose - The purpose of this research is to investigate the factors contributing to sustainable competitive advantage for multi-level marketing (MLM) firms in Malaysia. The selected variables in this study are company image, product innovation, leadership, distributor rewards system and distributor training system. Research design, data, and methodology - Quantitative research method is employed with collected sample size of 398 respondents using judgmental sampling technique. Normality and reliability test were performed in the first stage utilizing SPSS 22 and Confirmatory Factory Analysis (CFA) and variance analysis were obtained in the subsequent stage, following up with the overall fit of the measurement model, Structural Equation Model (SEM) using AMOS 22 with maximum likelihood estimation to assess the internal consistency, convergent validity and discriminant validity. Results - The research findings show that company image, leadership, distributor rewards system and distributor training system were supported and are factors affecting the sustainable competitive advantage of MLM companies in Malaysia. However, in this study, product innovation was not supported but this result does not depict that it is trivial and inconsequential in maintain sustainable advantage. Conclusion - Companies can build sustainable competitive advantage by focusing on these contributing factors. Several other comments and implications were brought to light and discussed in the paper.

The Evaluation of Geotube Behaviors on Muddy Beach: Field Monitoring and Numerical Analysis

Siew Cheng Lee,Roslan Hashim,Kim Hung Mo 대한토목학회 2018 KSCE JOURNAL OF CIVIL ENGINEERING Vol.22 No.11

The use of geotubes is now common in coastline protection due to notable advantages such as erosion prevention, competitive cost and speedy installation procedures. Previous researchers have presented analytical, empirical and numerical approaches for geotube design. However, design approach for geotube which functions as breakwater on deformable muddy foundation and subjected to hydrodynamic loads has not been well reported. Hence, this study evaluates the behavior of geotube breakwaters installed on a deformable muddy foundation based on field measurements and numerical analysis. The field measurements were carried out on quarter-yearly basis to assess the behavior of geotube under hydrodynamic forces. Two-dimensional finite element analysis was performed to simulate the deformation and the displacement of geotube breakwater subjected to hydrodynamic loads, taking into account of deformable foundation condition. The structural stability and structure’s height reduction due to foundation settlement are essential considerations in breakwater design. The agreements between field monitoring and numerical results were promising; therefore, the finite element models can be used to predict the behavior of geotube on those muddy coast areas with similar hydrodynamic and geological conditions.

International Students` Perception on University Cafeteria in Malaysia

Sang-Hyeop Lee,Mei Siew Liaw,Kai-Sean Lee,Young-Ah Rha 한국조리학회 2016 한국조리학회지 Vol.22 No.6

Kinetics of Thermal Inactivation of Peroxidases and Polyphenol Oxidase in Pineapple (Ananas comosus)

Ting Hun Lee,Lee Suan Chua,Eddie Ti Tjih Tan,Christina Yeong,Chew Ching Lim,Siew Yin Ooi,Ramlan bin Abdul Aziz,Azila binti Aziz,Mohd Roji bin Sarmidi 한국식품과학회 2009 Food Science and Biotechnology Vol.18 No.3

The heat tolerance and the inactivation kinetics of peroxidase (POD) and polyphenol oxidase (PPO) in pineapples (Ananas comosus) were studied in the temperature range 45-95℃. The kinetic parameters, such as deactivation rate constant (k), activation energy (Ea), and decimal reduction rate (D) of the thermal inactivation process, were determined. POD in pineapples showed biphasic inactivation behavior at temperatures range 45-75℃ but was monophasic at 85-95℃. This indicate that POD has 2 isozymes, namely heat labile and heat resistant, with Ea of 68.79 and 93.23 kJ/㏖, respectively. On the other hand, the heat denaturation of pineapple PPO could be described as simple monophasic first-order behavior with Ea of 80.15 kJ/㏖. Thus, the results of this study is useful in blanching technology where it shows a shortened time with higher temperature can be applied. The determination of the heat tolerance and inactivation POD and PPO, at different temperature range as done in the present work, was very important to improve the blanching process. This also will help to optimize the pineapple canning process which is one of the most important food industries in many tropical regions.

Comparison of Luminex NxTAG Respiratory Pathogen Panel and xTAG Respiratory Viral Panel FAST Version 2 for the Detection of Respiratory Viruses

Chun Kiat Lee,Hong Kai Lee,Christopher Wei Siong Ng,Lily Chiu,Julian Wei-Tze Tang,Tze Ping Loh,Evelyn Siew-Chuan Koay 대한진단검사의학회 2017 Annals of Laboratory Medicine Vol.37 No.3

Owing to advancements in molecular diagnostics, recent years have seen an increasing number of laboratories adopting respiratory viral panels to detect respiratory pathogens. In December 2015, the NxTAG respiratory pathogen panel (NxTAG RPP) was approved by the United States Food and Drug Administration. We compared the clinical performance of this new assay with that of the xTAG respiratory viral panel (xTAG RVP) FAST v2 using 142 clinical samples and 12 external quality assessment samples. Discordant results were resolved by using a laboratory-developed respiratory viral panel. The NxTAG RPP achieved 100% concordant negative results and 86.6% concordant positive results. It detected one coronavirus 229E and eight influenza A/H3N2 viruses that were missed by the xTAG RVP FAST v2. On the other hand, the NxTAG RPP missed one enterovirus/rhinovirus and one metapneumovirus that were detected by FAST v2. Both panels correctly identified all the pathogens in the 12 external quality assessment samples. Overall, the NxTAG RPP demonstrated good diagnostic performance. Of note, it was better able to subtype the influenza A/H3N2 viruses compared with the xTAG RVP FAST v2.

An update of the Malaysian Clinical Guidance on the management of glucocorticoid-induced osteoporosis, 2015

Swan Sim Yeap,Fen Lee Hew,Premitha Damodaran,Winnie Chee,Joon Kiong Lee,Emily Man Lee Goh,Siew Pheng Chan 대한골다공증학회 2017 Osteoporosis and Sarcopenia Vol.3 No.1

Objectives: This Clinical Guidance is aimed to help practitioners assess, diagnose and manage their patients with glucocorticoid-induced osteoporosis (GIO), using the best available evidence. Methods: A literature search using PubMed (MEDLINE) and The Cochrane Library identified all relevant articles on GIO and its assessment, diagnosis and treatment, from 2011, to update from the 2012 edition. The studies were assessed and the level of evidence assigned. For each statement, studies with the highest level of evidence were used to frame the recommendation. Results: Consider treatment early in all patients on glucocorticoids (GC) as fracture risk increases within 3e6 months of starting GC. The decision to start treatment for GIO depends on the presence of prior fracture, category of risk (as calculated using Fracture Risk Assessment Tool), daily dose and duration of GC treatment, age, and menopausal status. General measures include adequate calcium and vitamin D intake and reducing the dose of GC to the minimum required to achieve disease control. In patients on GC with osteoporotic fractures or confirmed osteoporosis on dual-energy X-ray absorptiometry, bisphosphonates are the first-line treatment. Treatment should be continued as long as patients remain on GC. Algorithms for the management of GIO in both pre- and post-menopausal women and men have been updated. Conclusions: In post-menopausal women and men above 50 years, bisphosphonates remain the mainstay of treatment in GIO. In pre-menopausal women and men below 50 years, bisphosphonates are recommended for those with a prevalent fracture or at very high risk only.

A summary of the Malaysian Clinical Guidance on the management of postmenopausal and male osteoporosis, 2015

Swan Sim Yeap,Fen Lee Hew,Premitha Damodaran,Winnie Chee,Joon Kiong Lee,Emily Man Lee Goh,Malik Mumtaz,Heng Hing Lim,Siew Pheng Chan 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.1

Aim: This Clinical Guidance is aimed to help practitioners assess, diagnose and manage their patients with osteoporosis (OP), using the best available evidence. Methods: A literature search using PubMed (MEDLINE) and The Cochrane Library identified all relevant articles on OP and its assessment, diagnosis and treatment, from 2011, to update from the 2012 edition. The studies were assessed and the level of evidence assigned. For each statement, studies with the highest level of evidence were used to frame the recommendation. Results: This article summarizes the diagnostic and treatment pathways for postmenopausal and male OP, while addressing the risk-benefit ratio for OP treatment. Recognising the limitation of only depending on bone mineral density in assessing fracture risk, a move to assess 10 year fracture risk using tools such as FRAX, is recommended as a guide to decision-making on when to start treatment. A re-evaluation was done of the position of calcium supplementation and on the importance of vitamin D. There has been concern about the potential adverse effects of the long-term usage of bisphosphonates, which have been discussed fully. Algorithms for the management of postmenopausal and male OP have been updated. Conclusions: Adequate intake of calcium (1000 mg from both diet and supplements) and vitamin D (800 IU) daily remain important adjuncts in the treatment of OP. However, in confirmed OP, pharmacological therapy with anti-resorptives is the mainstay of treatment in both men and postmenopausal women. Patients need to be regularly assessed while on medication and treatment adjusted as appropriate. © 2016 The Korean Society of Osteoporosis. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

A summary of the Malaysian Clinical Practice Guidelines on the management of postmenopausal osteoporosis, 2022

Terence Ing Wei Ong,Lee Ling Lim,Siew Pheng Chan,Winnie Siew Swee Chee,Alan Swee Hock Ch’ng,Elizabeth Gar Mit Chong,Premitha Damodaran,Fen Lee Hew,Luqman bin Ibrahim,Hui Min Khor,Pauline Siew Mei Lai 대한골다공증학회 2023 Osteoporosis and Sarcopenia Vol.9 No.2

Objectives: The aim of these Clinical Practice Guidelines is to provide evidence-based recommendations to assist healthcare providers in the screening, diagnosis and management of patients with postmenopausal osteoporosis (OP). Methods: A list of key clinical questions on the assessment, diagnosis and treatment of OP was formulated. A literature search using the PubMed, Medline, Cochrane Databases of Systematic Reviews, and OVID electronic databases identified all relevant articles on OP based on the key clinical questions, from 2014 onwards, to update from the 2015 edition. The articles were graded using the SIGN50 format. For each statement, studies with the highest level of evidence were used to frame the recommendation. Results: This article summarizes the diagnostic and treatment pathways for postmenopausal OP. Risk stratification of patients with OP encompasses clinical risk factors, bone mineral density measurements and FRAX risk estimates. Non-pharmacological measures including adequate calcium and vitamin D, regular exercise and falls prevention are recommended. Pharmacological measures depend on patients’ fracture risk status. Very high-risk individuals are recommended for treatment with an anabolic agent, if available, followed by an anti-resorptive agent. Alternatively, parenteral anti-resorptive agents can be used. High-risk individuals should be treated with anti-resorptive agents. In low-risk individuals, menopausal hormone replacement or selective estrogen receptor modulators can be used, if indicated. Patients should be assessed regularly to monitor treatment response and treatment adjusted, as appropriate.

Physical Activity and Quality of Life of Cancer Survivors: A Lack of Focus for Lifestyle Redesign

Lee, Jia Ern,Loh, Siew Yim Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.4

Background: Physical activity is a component of lifestyle activity and one that has been increasingly seen as 'the medicine' to cure chronic diseases, including certain types of cancer. Physical activity has potent impact on mortality but only if it is well incorporated as lifestyle activity may it allow a better outcome of the quality of life of cancer survivors. This paper presents a review on the evidence of physical activity being actively promoted as lifestyle activity amongst cancer survivors, for the last five years. Materials and Methods: Electronic databases were systematically searched for randomized controlled trials incorporated as lifestyle activity through MEDLINE with the associated terms "physical activity or exercise", "quality of life" and "cancer survivor or people with cancer", 'lifestyle' and 'randomised controlled trial'. The period of search was confined to publication within January 2008 till December 2012 and further limits were to full text, peer reviewed, abstract available and English language. Results: Based on inclusion criteria, 45 articles were retrieved. Of these, 41 were excluded after examining the full paper. Four final articles on randomized controlled trials were studied to determine the effectiveness of PA to improve the quality of life in post treatment cancer survivors and positive associations were found. Conclusions: Physical activity is related to better quality of life of cancer survivors. Only one paper had characteristics of lifestyle incorporation for a lifestyle redesign, but none overtly or actively promoting exercise interventions as an essential lifestyle activity. With increasing survivorship, the benefits of physical activity must be aggressively and overtly promoted to optimize its positive impact.