Parental affordability and willingness to pay for universal masking amongst government school students in Kuching, Sarawak.

INTRODUCTION: Financial affordability to purchase commodities for disease prevention is an important public health issue. The objective of this paper is to report the financial affordability and willingness to pay amongst the parents of government students for their children's nonmedical mask use, using a newly created Household Face Mask Affordability Questionnaire (MAQ). MATERIALS AND METHODS: This was a cross-sectional study involving the parents or guardians of 50.6% (44/87) government schools in the whole of Kuching Division of Sarawak. The sampling method was multistage cluster sampling, whereby stage one involved random sampling of 49.2% (30/61) primary schools and 53.8% (14/46) secondary schools in the Kuching Division, followed by stage two cluster sampling of one class per non-examination standard in each randomly sampled school. All students in the sampled classes were asked to bring a face-validated questionnaire (MAQ) back home to be answered by one of their parents or a guardian. A total of 2559 out of 3661 distributed questionnaires were collected, with a response rate of 70%. The data collection period was between April and June of 2022 so as the recall bias of the information collected, especially on the actual spending on the face masks for the school going students, was minimised. The relevant summary statistics for self-perceived face masks characteristics, face mask expenses, affordability and willingness to pay were calculated. We regress separately the monthly affordability and willingness to pay amount against age, occupation, marital status, total number of children, monthly income and monthly saving to build predictive models for affordability and willingness to pay amount per child per month. RESULTS: The average Scale-level Face Validity Indexes for all aspects of validity (clarity, comprehension, relevancy, representativeness) are high (0.91 to 1.00) for MAQ. Most of the respondents were mothers, married, working as private employees with a mean age of 41 and belonged to the B40 and M40 group. The average monthly saving per family was RM540, which was about 15% of the total income. The average actual monthly spending to purchase face masks for one child is RM24. On average, a family can afford to pay RM23.80 for one child per month to purchase face masks. The willingness to pay for the same was RM25.27. The median affordability, willingness to pay and actual spending for face masks per child was RM16.67 per month. Taking 75th percentile as the reasonable maximum expenses per child for face masks per month, the affordable amount by most parents is RM30, with the willingness to pay at 10% higher. Affordability to purchase a face mask is influenced by the marital status, occupation, income, saving and the number of dependent of the breadwinner of a household. The most important face mask characteristics expected by the parents are better filtration efficiency and easier breathability. CONCLUSION: The affordability and willingness to pay the amount to purchase face masks amongst parents of government students in Sarawak were RM30 and RM33 per child per month, respectively.

Fluctuation of BCR-ABL1 qPCRIS level beyond 0.1%IS after stopping tyrosine kinase inhibitor in chronic myeloid leukaemia patients with deep molecular response for at least two years.

Fluctuation of BCR-ABL1 real-time quantitative polymerase chain reaction in International Scale (qPCRIS) level below major molecular response (MMR) (0.1%IS) is a known phenomenon after stopping tyrosine kinase inhibitor (TKI) in chronic myeloid leukaemia (CML) patients who are attempting treatment free remission (TFR). We report here four cases of fluctuation beyond MMR during conduct of a Malaysia Stop TKI Trial (MSIT) to examine the validity of the commonly used relapse criterion - loss of MMR for one reading - aiming to provide evidence in setting relapse criteria for future CML patients who want to attempt TFR.

The epidemiology of chronic myeloid leukaemia in southern Sarawak, Borneo Island.

OBJECTIVES: There are very few published chronic myeloid leukaemia (CML) epidemiology studies in South-East Asia and no representative from Malaysia. METHODS: This is a cross-sectional study of adult CML patients (citizen) in a single but representative centre in southern Sarawak. RESULTS: Total 79 patients (Malay 39%, Chinese 30.4%, Iban 17.7%, Bidayuh 12.7%) were identified from the databases. Median age at diagnosis was younger, 40, compared to developed countries due to population structure. M:F ratio was higher, 2.6:1 compared to other countries 1.3-1.7:1. Majority presented at chronic phase (89.5%), low/intermediate risk score (80%) and started imatinib (96%) as first line tyrosine kinase inhibitor (TKI), which 40% of them switched to other TKI due to intolerance (17%) and failure (including disease progression)/not achieving major molecular response (83%). Quantitative polymerase chain reaction (qPCR) assessment after three months of TKI treatment had higher positive predictive value to predict Imatinib failure, 75%, than qPCR assessment after six months of TKI treatment, 58%. Presenting phase, symptoms, signs and laboratory data were like most countries. Estimated prevalence and incidence of CML in southern Sarawak was 69.2/1,000,000 population at the Year 2016 (similar to most developing countries) and 8.0/1,000,000 population per year at the Year 2011-2016 (similar to most countries), respectively. The incidence increased with age and was lowest among Iban, 12.8 and highest among Chinese, 19.5, which was 4x higher than Chinese in China. The prevalence of different BCR-ABL1 transcript type was like other Asia countries CONCLUSION: Significant epidemiological differences on M:F ratio and ethnic groups compared to other countries warrant further study.

Metabolic engineering of Saccharomyces cerevisiae for production of novel lipid compounds.

The yeast Saccharomyces cerevisiae has been modified successfully for production of numerous metabolites and therapeutic proteins through metabolic engineering, but has not been utilized to date for the production of lipid-derived compounds. We developed a lipid metabolic engineering strategy in S. cerevisiae based upon culturing techniques that are typically employed for studies of peroxisomal biogenesis; cells were grown in media containing fatty acids as a sole carbon source, which promotes peroxisomal proliferation and induction of enzymes associated with fatty acid beta-oxidation. Our results indicate that growth of yeast on fatty acids such as oleate results in extensive uptake of these fatty acids from the media and a subsequent increase in total cellular lipid content from 2% to 15% dry cell weight. We also show that co-expression of plant fatty acid desaturases 2 and 3 ( FAD2 and FAD3), using a fatty acid-inducible peroxisomal gene promoter, coupled the processes of fatty acid uptake with the induction of a new metabolic pathway leading from oleic acid (18:1) to linolenic acid (18:3). Finally, we show that cultivation of yeast cells in the presence of triacylglycerols and exogenously supplied lipase promotes extensive incorporation of triglyceride fatty acids into yeast cells. Collectively, these results provide a framework for bioconversion of low-cost oils into value-added lipid products.

An immobilized hexokinase enzyme stirrer for a simple and economical assay of plasma glucose.

We have adapted the hexokinase glucose procedure to an immobilized enzyme stirrer for the determination of glucose concentrations in human blood plasma. The procedure is a fluorometric rate method measuring the formation of NADPH catalyzed by immobilized glucose-6-phosphate dehydrogenase and hexokinase held within a tiny stirrer. The enzyme stirrer is stable for at least two months and can be used over eight-hundred assays without any loss of activity.

Determination of plasma glucose with use of a stirrer containing immobilized glucose dehydrogenase.

A stirrer containing immobilized glucose dehydrogenase has been successfully used for determining glucose in plasma. The device is usable for at least two months and for about 500 assays. The reaction was measured kinetically and linearity was observed to 4 g of glucose per liter. Tested with aqueous glucose and with deproteinized plasma, within-day and day-to-day precision were good. Interference and method-comparison (hexokinase method) were examined. The performance of this system makes the technique useful and attractive for routine use in small-volume clinical laboratories.

Measurement of glucose in plasma, with use of immobilized glucose oxidase and peroxidase.

We describe a novel fluorometric technique for simple, rapid, and economical assay of glucose by use of immobilized glucose oxidase and peroxidase. A cylindrical magnetic stirrer was specially designed to hold the immobilized enzymes firmly and to allow the reaction minzymic transformation quickly. Blood plasma can be assayed directly with no pretreatment. Ascrobic acid, uric acid, and creatinine in concenctrations of 0.25, 0.25, and 0.2 g/liter, respectively, did not interfere. The linearity of the assay was extended to 4.0 g of glucose concentrations. Results by our technique and by the otoluidine or hexokinase methods agreed well. The immobilized enzymes are stable for several months and can be used for several hundred highly accurate and reproducible assays.

Semi-solid surface fluorometric analysis of glucose.

We describe an enzymatic fluorometric method for determining glucose concentrations in blood samples by analysis on a semi-solid surface (silicone-rubber pads). The method is an adaptation of existing spectrophotometric procedures based on the sequential coupling reactions with glucose-6-phosphate dehydrogenase and NADP+. The rate of appearance of NADPH fluorescence at 460 nm (excitation wavelength, 340 nm) is monitored and related to the glucose concentration in plasma or serum. The calibration curve is linear to 2.50 g/liter. The chief advantages of this method over the spectrophotometric procedure are low cost and rapid response. The results obtained correlate well with those of the o-toluidine method (correlation coefficient, 0.986).