Publications by authors named "Yvonne Lim"

Colorectal cancer (CRC), an emerging public health concern, is one of the leading causes of cancer morbidity and mortality worldwide. An increasing body of evidence shows that dysfunction in metabolic reprogramming is a crucial characteristic of CRC progression. Specifically, metabolic reprogramming abnormalities in glucose, glutamine and lipid metabolism provide the tumour with energy and nutrients to support its rapid cell proliferation and survival.

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Dengue remains the most rapidly advancing vector-borne disease in the world, and while the disease burden is predominantly in low-to-middle-income countries, the association with poverty remains in question. Consequently, a study was undertaken to evaluate the prevalence of anti-dengue antibodies among individuals residing in the People's Housing Program (PPR), a government-sponsored low-cost housing initiative targeting low-income earners. This type of public housing often faces challenges, including substandard housing facilities.

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  • The study investigates soil-transmitted helminth (STH) infections among Malaysia's indigenous Negritos, finding a high overall prevalence of 63.3% despite past intervention efforts.
  • Trichuris trichiura and Ascaris lumbricoides are the most common infections, with moderate-to-heavy infections significantly linked to the presence of infections in other household members.
  • The results highlight the urgent need for comprehensive anthelmintic treatment for all age groups and recommend local policy changes to target older members of the Orang Asli community to improve health outcomes for future generations.
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  • James Neel's Thrifty Genotype Hypothesis suggests that genetic traits promoting energy conservation and fat storage were advantageous during resource-scarce periods in human evolution but now contribute to modern health issues like obesity and type 2 diabetes in industrialized societies.
  • Despite its popularity and extensive citations, the applicability of the Thrifty Genotype Hypothesis to current human health remains debatable, leading to exploration of other theories such as the Evolutionary Mismatch Hypothesis.
  • The text emphasizes the need for new empirical research, particularly through partnerships with transitioning subsistence-level communities, to better understand the impact of evolutionary history on modern cardiometabolic health, using the Orang Asli of Malaysia as a case study.
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  • * A study involving 596 schoolchildren aged 8-12 years revealed a high prevalence of xerophthalmia (48.8%), primarily identified by conjunctival xerosis, and linked to factors like malnutrition and socio-demographic status.
  • * Boys and indigenous Orang Asli children showed a higher risk for xerophthalmia, while overweight/obese children had a lower risk, highlighting the need for targeted interventions to address VAD and its related health issues in these communities.
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  • Skin infections significantly burden underserved communities, particularly the isolated Negrito tribes of Peninsular Malaysia, with a notable study revealing a 35.6% overall prevalence.
  • Major infections found were scabies (11.7%), tinea versicolor (11.3%), and tinea imbricata (7.5%), with higher rates in resettled villages compared to inland ones.
  • The study emphasizes the need for targeted interventions, linking specific infections to environmental factors and lifestyle choices, to improve healthcare access and support for these communities.
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Characterizing DNA methylation patterns is important for addressing key questions in evolutionary biology, geroscience, and medical genomics. While costs are decreasing, whole-genome DNA methylation profiling remains prohibitively expensive for most population-scale studies, creating a need for cost-effective, reduced representation approaches (i.e.

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Background: Many subsistence-level and Indigenous societies around the world are rapidly experiencing urbanization, nutrition transition, and integration into market-economies, resulting in marked increases in cardiometabolic diseases. Determining the most potent and generalized drivers of changing health is essential for identifying vulnerable communities and creating effective policies to combat increased chronic disease risk across socio-environmental contexts. However, comparative tests of how different lifestyle features affect the health of populations undergoing lifestyle transitions remain rare, and require comparable, integrated anthropological and health data collected in diverse contexts.

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Over the last five decades, widespread industrialisation and urbanisation have resulted in the influx of low-skilled workers, particularly from Southeast and West Asia to Malaysia. The current practice for migrant workers entry for employment requires mandatory medical screening for infectious diseases. However, screening for parasitic infections in Malaysia is woefully inadequate.

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  • The research evaluates the shift from traditional clinical trial design for heart failure (HF) to a data-driven approach, utilizing natural language processing to analyze trial eligibility criteria.
  • Phase III trials for HF were examined to identify common inclusion and exclusion criteria, finding that only about 20% of registry patients were eligible for these trials.
  • Over time, the trials have become more restrictive, with a significant decline in patient eligibility from 40% in earlier years to 19% in recent years, highlighting the need for a better design framework for future trials.
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  • * A study in Malaysia examined 134 cancer patients and 17 healthy controls to assess the prevalence of IPIs and how they affect gut microbiota composition, finding a 32.8% prevalence of IPIs among cancer patients.
  • * Results indicated significant differences in gut microbiota diversity between cancer patients and healthy controls, as well as distinct bacterial compositions between parasite-infected and non-infected cancer patients, suggesting that intestinal parasites may disrupt normal gut microbiota balance in this vulnerable group.
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Background: Parasitic helminths influence the composition of the gut microbiome. However, the microbiomes of individuals living in helminth-endemic regions are understudied. The Orang Asli, an indigenous population in Malaysia with high burdens of the helminth Trichuris trichiura, display microbiotas enriched in Clostridiales, an order of spore-forming obligate anaerobes with immunogenic properties.

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Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity.

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Background: Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks.

Study Design: We conducted an interrupted time series analysis to examine rates of cataract surgery before and during the lockdown.

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In indigenous populations where soil-transmitted helminths (STH) infections are endemic, STH parasites (i.e., , , hookworms) often co-exist and co-evolve with the gut microbiota of their human hosts.

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Purpose: Vitamin A deficiency (VAD) remains a significant contributor to childhood morbidity and mortality in developing countries; therefore, the implementation of sustainable and cost-effective approaches to control VAD is of utmost pertinence. This study aims to investigate the efficacy of red palm olein (RPO)-enriched biscuit supplementation in improving vitamin A, haematological, iron, and inflammatory status among vitamin A-deficient schoolchildren.

Methods: We conducted a double-blinded, randomised controlled trial involving 651 rural primary schoolchildren (8-12 years) with VAD in Malaysia.

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The incidence of oropharyngeal cancer (OPSCC) has escalated in the past few decades; this has largely been triggered by high-risk human papillomavirus (HPV). Early cancer screening is needed for timely clinical intervention and may reduce mortality and morbidity, but the lack of knowledge about premalignant lesions for OPSCC poses a significant challenge to early detection. Biomarkers that identify individuals at high risk for OPSCC may act as surrogate markers for precancer but these are limited as only a few studies decipher the multistep progression from HPV infection to OPSCC development.

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Humans are in a complex symbiotic relationship with a wide range of microbial organisms, including bacteria, viruses, and fungi. The evolution and composition of the human microbiome can be an indicator of how it may affect human health and susceptibility to diseases. Microbiome alteration, termed as dysbiosis, has been linked to the pathogenesis and progression of hematological cancers.

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Sharing individual patient data (IPD) is a simple concept but complex to achieve due to data privacy and data security concerns, underdeveloped guidelines, and legal barriers. Sharing IPD is additionally difficult in big data-driven collaborations such as Bigdata@Heart in the Innovative Medicines Initiative, due to competing interests between diverse consortium members. One project within BigData@Heart, case study 1, needed to pool data from seven heterogeneous data sets: five randomized controlled trials from three different industry partners, and two disease registries.

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Article Synopsis
  • * The evolutionary mismatch hypothesis suggests that humans evolved under environments that are now drastically different, leading to genetic traits that may contribute to these diseases today.
  • * The proposal involves using genomic tools with subsistence-level groups adapting to new lifestyles, allowing researchers to study genetic and environmental influences on NCDs across various ancestries and cultures.
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The incidence of human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) is rising rapidly and has exceeded cervical cancer to become the most common HPV-induced cancer in developed countries. Since patients with HPV + OPSCC respond very favorably to standard aggressive treatment, the emphasis has changed to reducing treatment intensity. However, recent multi-center clinical trials failed to show non-inferiority of de-escalation strategies on a population basis, highlighting the need to select low-risk patients likely to respond to de-intensified treatments.

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  • - The study investigated the rates and predictors of oral and gastrointestinal mucositis in patients undergoing hematopoietic stem cell transplant (HSCT), emphasizing the relationship between inflammation markers and mucositis severity.
  • - Over 142 patients were monitored, revealing high prevalence rates of oral (68.3%) and gastrointestinal mucositis (95.8%), with factors like specific treatment regimens and patient characteristics significantly affecting mucositis severity.
  • - Cytokine levels in saliva and plasma were linked to the severity of oral mucositis, providing valuable real-world insights for managing and predicting mucositis in HSCT patients.
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Mucositis is a debilitating complication of hematopoietic stem cell transplantation (HSCT). It is unclear how changes in the composition of microbiota, which are modulated by geographical location and ethnicity, may influence immune regulation leading to the development of mucositis, and the study of both oral and gut microbiota in a single population of autologous HSCT in the Asian region is lacking. The present study aimed to characterize the oral and gut microbiota changes, and the impact on both oral and lower gastrointestinal (GI) mucositis, with associated temporal changes in a population of adult recipients of autologous HSCT.

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Parasitic helminths influence the composition of the gut microbiome. However, the microbiomes of individuals living in helminth-endemic regions are understudied. The Orang Asli, an indigenous population in Malaysia with high burdens of the helminth , displayed microbiotas enriched in Clostridiales, an order of spore-forming obligate anaerobes previously shown to have immunogenic properties.

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Aims: In order to understand how sex differences impact the generalizability of randomized clinical trials (RCTs) in patients with heart failure (HF) and reduced ejection fraction (HFrEF), we sought to compare clinical characteristics and clinical outcomes between RCTs and HF observational registries stratified by sex.

Methods And Results: Data from two HF registries and five HFrEF RCTs were used to create three subpopulations: one RCT population (n = 16 917; 21.7% females), registry patients eligible for RCT inclusion (n = 26 104; 31.

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