Browse publications by year: 2021

  1. Tao X, Hanif H, Ahmed HH, Ebrahim NA
    Front Psychol, 2021;12:722332.
    PMID: 34733204 DOI: 10.3389/fpsyg.2021.722332
    Numerous students suffer from academic procrastination; it is a common problem and phenomenon in academic settings. Many previous researchers have analyzed its relationships with other factors, such as self-regulation and academic success. This paper aims to provide a full outline of academic procrastination and explore the current hot spots and trends. Bibliometrix and VOSviewer were used to conduct quantitative analysis. The data was collected from the Web of Science core collection database, which contains 1,240 articles from the years 1938 to 2021. The analysis shows that the publication of articles on academic procrastination has been rapidly increasing since 1993. In terms of the most influential countries and institutions, the United states took a prominent lead among all countries, and the most productive institutions in this area were the University of Washington and University of California, Los Angeles. By analyzing the authors, we see that most authors like working with a few collaborators, leading to main groups of authors, such as Murat Balkis and June J. Pilcher. The most frequently cited author was Esther D. Rothblum. Based on the co-citation journals network, Personality and Individual Differences was the prolific and influential journal referring to the number of citations and articles it received. The VOSviewer tool identified the hot spots of academic procrastination, which were mainly distributed as follows: (a) procrastination, (b) academic procrastination, (c) self-regulation, (d) academic performance, and (e) motivation. Therefore, this paper is helpful for scholars and practitioners to know the trend of academic procrastination research comprehensively.
  2. Zhang J, Zhang M, Liu Y, Lyu R, Cui R
    Front Psychol, 2021;12:728182.
    PMID: 34733207 DOI: 10.3389/fpsyg.2021.728182
    The rapid development of digital technology has created a variety of forms of digital media. In these emerging media, with the support of high-performance computers, increasingly dynamic performance has become possible, and the public has cultivated a preference for dynamic content cognition. This study, based on the basic characteristics of visual perception to the cognition of motion form, aims to cultivate the cognitive literacy of pan-digital media with innovative concepts and entrepreneurship education and to explore the cognition and innovative expression methods of dynamic language in digital design. The research leads the static oriented morphological exploration and expression to the dynamic expression and thinking of the same concept object. The basic thinking steps for students from "static" to "dynamic" are established, and students are encouraged to use "Synesthesia," "metaphor" and other methods to carry out a "dynamic expression" level of emotional association. In the experiment, two different ways of design expression, static and dynamic, are required to design and evolve graphics. In this study, 50 freshmen were selected as the training objects for the planning and training of design thinking and performance means. In the visual elaboration and expression of the inner emotion of the same content with innovative concept and entrepreneurship education, not only should the changes and combinations of the graphics be innovated, but the emotional characteristics of the more abstract graphics should be explored as well. The feedback data of students' thinking and cognition differences in the two stages of expression were obtained through a questionnaire and analyzed and compared. The experimental results show that after the training, students' ability to develop innovative concepts and entrepreneurship education through dynamic expression, consciousness and perception were significantly improved. This research also provides a new vision and specific implementation method for the future training of digital dynamic innovation expression ability and the cultivation of innovative concepts of digital media literacy and entrepreneurship education.
  3. Wang C, Zainal NS, Chai SJ, Dickie J, Gan CP, Zulaziz N, et al.
    Front Immunol, 2021;12:763086.
    PMID: 34733290 DOI: 10.3389/fimmu.2021.763086
    HPV-independent head and neck squamous cell carcinoma (HNSCC) is a common cancer globally. The overall response rate to anti-PD1 checkpoint inhibitors (CPIs) in HNSCC is ~16%. One major factor influencing the effectiveness of CPI is the level of tumor infiltrating T cells (TILs). Converting TILlow tumors to TILhigh tumors is thus critical to improve clinical outcome. Here we describe a novel DNA vaccines to facilitate the T-cell infiltration and control tumor growth. We evaluated the expression of target antigens and their respective immunogenicity in HNSCC patients. The efficacy of DNA vaccines targeting two novel antigens were evaluated with or without CPI using a syngeneic model. Most HNSCC patients (43/44) co-expressed MAGED4B and FJX1 and their respective tetramer-specific T cells were in the range of 0.06-0.12%. In a preclinical model, antigen-specific T cells were induced by DNA vaccines and increased T cell infiltration into the tumor, but not MDSC or regulatory T cells. The vaccines inhibited tumor growth and improved the outcome alone and upon combination with anti-PD1 and resulted in tumor clearance in approximately 75% of mice. Pre-existence of MAGED4B and FJX1-reactive T cells in HNSCC patients suggests that these widely expressed antigens are highly immunogenic and could be further expanded by vaccination. The DNA vaccines targeting these antigens induced robust T cell responses and with the anti-PD1 antibody conferring excellent tumor control. This opens up an opportunity for combination immunotherapy that might benefit a wider population of HNSCC patients in an antigen-specific manner.
    MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Antigens, Neoplasm/immunology*; Combined Modality Therapy; Female; Humans; Male; Mice, Inbred C57BL; Middle Aged; T-Lymphocytes/immunology; Lymphocytes, Tumor-Infiltrating/immunology; Vaccines, DNA/immunology*; Cancer Vaccines/immunology*; Mice; Young Adult
  4. Lim SL, Tay VY, Bhullar A, Baharuddin H, Ch'ng SS, Yusoof HM, et al.
    Oman Med J, 2021 Sep;36(5):e305.
    PMID: 34733551 DOI: 10.5001/omj.2022.34
    Objectives: The Coronavirus Disease 2019 (COVID-19) outbreak is a global pandemic and has caught the attention of the rheumatology fraternity, where patients are thought to be at higher risk of infection. We aimed to study the incidence of COVID-19 infection and depression and anxiety symptoms among patients with rheumatic disease (RD) in Hospital Selayang, Malaysia, during the COVID-19 pandemic.

    Methods: A cross-sectional study was conducted via phone interview using a structured questionnaire in patients with RD aged > 18 years old scheduled for clinic appointments from 4 to 28 May 2020, which coincided with the second wave of COVID-19 cases in Malaysia. The questionnaire included demographics, COVID-19 screening questions, depression and anxiety symptoms screening using questions derived from the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2).

    Results: Among the 361 patients enrolled, the majority were females (83.1%), and over half (54.3%) were ethnic Malays, 41.6% had rheumatoid arthritis, 34.6% had systemic lupus erythematosus, 12.2% had spondyloarthropathy, and only one (0.3%) patient had COVID-19 infection. The mean age of patients was 48.2 years (range: 16-80 years). The frequency of patients with depression and anxiety symptoms was 8.6% and 6.9%, respectively. Married patients reported feeling more anxious (p =0.013), while patients with tertiary education levels reported feeling more depressed (p =0.012).

    Conclusions: The incidence of COVID-19 infection is low, probably due to the low rate of testing. Depression and anxiety symptoms reported by patients in our cohort were modest. Our findings suggest that the COVID-19 pandemic has a greater impact on married patients with RD and those with a higher education level.

  5. Yeoh Y, Low TY, Abu N, Lee PY
    PeerJ, 2021;9:e12338.
    PMID: 34733591 DOI: 10.7717/peerj.12338
    Resistance to anti-cancer treatments is a critical and widespread health issue that has brought serious impacts on lives, the economy and public policies. Mounting research has suggested that a selected spectrum of patients with advanced colorectal cancer (CRC) tend to respond poorly to both chemotherapeutic and targeted therapeutic regimens. Drug resistance in tumours can occur in an intrinsic or acquired manner, rendering cancer cells insensitive to the treatment of anti-cancer therapies. Multiple factors have been associated with drug resistance. The most well-established factors are the emergence of cancer stem cell-like properties and overexpression of ABC transporters that mediate drug efflux. Besides, there is emerging evidence that signalling pathways that modulate cell survival and drug metabolism play major roles in the maintenance of multidrug resistance in CRC. This article reviews drug resistance in CRC as a result of alterations in the MAPK, PI3K/PKB, Wnt/β-catenin and Notch pathways.
  6. Akhtar A, Ahmad Hassali MA, Zainal H, Ali I, Khan AH
    Front Public Health, 2021;9:657199.
    PMID: 34733812 DOI: 10.3389/fpubh.2021.657199
    Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.
    MeSH terms: Aged; Cross-Sectional Studies; Humans; Male; Retrospective Studies; Prevalence; Treatment Outcome
  7. Lee SY, Ma J, Khoo TS, Abdullah N, Nik Md Noordin Kahar NNF, Abdul Hamid ZA, et al.
    Front Bioeng Biotechnol, 2021;9:735090.
    PMID: 34733829 DOI: 10.3389/fbioe.2021.735090
    Stem cell-based therapy appears as a promising strategy to induce regeneration of damaged and diseased tissues. However, low survival, poor engraftment and a lack of site-specificity are major drawbacks. Polysaccharide hydrogels can address these issues and offer several advantages as cell delivery vehicles. They have become very popular due to their unique properties such as high-water content, biocompatibility, biodegradability and flexibility. Polysaccharide polymers can be physically or chemically crosslinked to construct biomimetic hydrogels. Their resemblance to living tissues mimics the native three-dimensional extracellular matrix and supports stem cell survival, proliferation and differentiation. Given the intricate nature of communication between hydrogels and stem cells, understanding their interaction is crucial. Cells are incorporated with polysaccharide hydrogels using various microencapsulation techniques, allowing generation of more relevant models and further enhancement of stem cell therapies. This paper provides a comprehensive review of human stem cells and polysaccharide hydrogels most used in regenerative medicine. The recent and advanced stem cell microencapsulation techniques, which include extrusion, emulsion, lithography, microfluidics, superhydrophobic surfaces and bioprinting, are described. This review also discusses current progress in clinical translation of stem-cell encapsulated polysaccharide hydrogels for cell delivery and disease modeling (drug testing and discovery) with focuses on musculoskeletal, nervous, cardiac and cancerous tissues.
  8. Yusof KM, Groen K, Rosli R, Avery-Kiejda KA
    Front Cell Dev Biol, 2021;9:732415.
    PMID: 34733847 DOI: 10.3389/fcell.2021.732415
    Secondary lymphedema is characterized by lymphatic fluid retention and subsequent tissue swelling in one or both limbs that can lead to decreased quality of life. It often arises after loss, obstruction, or blockage of lymphatic vessels due to multifactorial modalities, such as lymphatic insults after surgery, immune system dysfunction, deposition of fat that compresses the lymphatic capillaries, fibrosis, and inflammation. Although secondary lymphedema is often associated with breast cancer, the condition can occur in patients with any type of cancer that requires lymphadenectomy such as gynecological, genitourinary, or head and neck cancers. MicroRNAs demonstrate pivotal roles in regulating gene expression in biological processes such as lymphangiogenesis, angiogenesis, modulation of the immune system, and oxidative stress. MicroRNA profiling has led to the discovery of the molecular mechanisms involved in the pathophysiology of auto-immune, inflammation-related, and metabolic diseases. Although the role of microRNAs in regulating secondary lymphedema is yet to be elucidated, the crosstalk between microRNAs and molecular factors involved in the pathological features of lymphedema, such as skin fibrosis, inflammation, immune dysregulation, and aberrant lipid metabolism have been demonstrated in several studies. MicroRNAs have the potential to serve as biomarkers for diseases and elucidation of their roles in lymphedema can provide a better understanding or new insights of the mechanisms underlying this debilitating condition.
  9. Srinivasan E, Chandrasekhar G, Chandrasekar P, Anbarasu K, Vickram AS, Karunakaran R, et al.
    Front Med (Lausanne), 2021;8:736978.
    PMID: 34733860 DOI: 10.3389/fmed.2021.736978
    Parkinson's disease (PD), a neurodegenerative disorder characterized by distinct aging-independent loss of dopaminergic neurons in substantia nigra pars compacta (SNpc) region urging toward neuronal loss. Over the decade, various key findings from clinical perspective to molecular pathogenesis have aided in understanding the genetics with assorted genes related with PD. Subsequently, several pathways have been incriminated in the pathogenesis of PD, involving mitochondrial dysfunction, protein aggregation, and misfolding. On the other hand, the sporadic form of PD cases is found with no genetic linkage, which still remain an unanswered question? The exertion in ascertaining vulnerability factors in PD considering the genetic factors are to be further dissevered in the forthcoming decades with advancement in research studies. One of the major proponents behind the prognosis of PD is the pathogenic transmutation of aberrant alpha-synuclein protein into amyloid fibrillar structures, which actuates neurodegeneration. Alpha-synuclein, transcribed by SNCA gene is a neuroprotein found predominantly in brain. It is implicated in the modulation of synaptic vesicle transport and eventual release of neurotransmitters. Due to genetic mutations and other elusive factors, the alpha-synuclein misfolds into its amyloid form. Therefore, this review aims in briefing the molecular understanding of the alpha-synuclein associated with PD.
  10. Masrani AS, Nik Husain NR, Musa KI, Yasin AS
    Biomed Res Int, 2021;2021:3540964.
    PMID: 34734083 DOI: 10.1155/2021/3540964
    Introduction: Dengue, a vector-borne viral illness, shows worldwide widening spatial distribution beyond its point of origination, namely, the tropical belt. The persistent hyperendemicity in Malaysia has resulted in the formation of the dengue early warning system. However, weather variables are yet to be fully utilized for prevention and control activities, particularly in east-coast peninsular Malaysia where limited studies have been conducted. We aim to provide a time-based estimate of possible dengue incidence increase following weather-related changes, thereby highlighting potential dengue outbreaks.

    Method: All serologically confirmed dengue patients in Kelantan, a northeastern state in Malaysia, registered in the eDengue system with an onset of disease from January 2016 to December 2018, were included in the study with the exclusion of duplicate entry. Using a generalized additive model, climate data collected from the Kota Bharu weather station (latitude 6°10'N, longitude 102°18'E) was analysed with dengue data.

    Result: A cyclical pattern of dengue cases was observed with annual peaks coinciding with the intermonsoon period. Our analysis reveals that maximum temperature, mean temperature, rainfall, and wind speed have a significant nonlinear effect on dengue cases in Kelantan. Our model can explain approximately 8.2% of dengue incidence variabilities.

    Conclusion: Weather variables affect nearly 10% of the dengue incidences in Northeast Malaysia, thereby making it a relevant variable to be included in a dengue early warning system. Interventions such as vector control activities targeting the intermonsoon period are recommended.

  11. Ransing R, de la Rosa PA, Pereira-Sanchez V, Handuleh JIM, Jerotic S, Gupta AK, et al.
    PMID: 34735077 DOI: 10.47626/2237-6089-2021-0263
    INTRODUCTION: Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries.

    METHODS: PubMed and Google Scholar were searched for published studies from 2010 to 2020. Searches were conducted by using the relevant country of interest as a search term (e.g. "Iran"), as well as relevant predefined keywords such as "cannabis", "marijuana", "hashish", "bhang "dual diagnosis", "use", "addiction", "prevalence", "co-morbidity", "substance use disorder", "legalization" or "policy" (English and non-English). These keywords were used in multiple combinations to create the search string in studies records' titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English (national language country) languages to identify the current state of cannabis use, policies, and research in each of those countries.

    RESULTS: Inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and intervention strategies across the reviewed countries were the main findings. European countries have dominated cannabis research output in PubMed, as compared to Asian countries (Thailand, Malaysia, India, Iran and Nepal).

    CONCLUSIONS: Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

  12. Shahiduzzaman M, Chen B, Akhtaruzzaman M, Wang L, Fukuhara H, Tomita K, et al.
    ACS Appl Mater Interfaces, 2021 Nov 17;13(45):53758-53766.
    PMID: 34735118 DOI: 10.1021/acsami.1c13793
    In this study, the spontaneous microstructure tuning of TiO2 was observed by aging the ethanol/water TiO2 paste for up to 20 days at ambient conditions. A dynamic light scattering study reveals that it formed the outstanding reproducible TiO2 microstructure with a ∼200 nm average particle size and stabilizes in 6 to 20 days under an ambient atmosphere. Interestingly, the as-deposited day 15 sample spontaneously changed its crystallinity upon keeping the paste at ambient conditions; meanwhile the day 0 sample showed an amorphous structure. A dense, uniform, and stable TiO2 electrode was cast on a fluorine doped-tin oxide substrate using the electrospray technique. We exploit the spontaneous evolution of the TiO2 nanopowder to revisit the fabrication procedure of the TiO2 photoelectrode for dye-sensitized solar cells (DSSCs). The controlled microstructure TiO2 film was used in DSSCs, which, to the best of our knowledge, achieved the highest power conversion efficiency of 9.65% using N719 dye in sensitizing the TiO2 photoanode.
  13. Butt M, Sattar A, Abbas T, Hussain R, Ijaz M, Sher A, et al.
    PLoS One, 2021;16(11):e0257893.
    PMID: 34735478 DOI: 10.1371/journal.pone.0257893
    Climate change is causing soil salinization, resulting in huge crop losses throughout the world. Multiple physiological and biochemical pathways determine the ability of plants to tolerate salt stress. Chili (Capsicum annum L.) is a salt-susceptible crop; therefore, its growth and yield is negatively impacted by salinity. Irreversible damage at cell level and photo inhibition due to high production of reactive oxygen species (ROS) and less CO2 availability caused by water stress is directly linked with salinity. A pot experiment was conducted to determine the impact of five NaCl salinity levels, i.e., 0,1.5, 3.0, 5.0 and 7.0 dS m-1 on growth, biochemical attributes and yield of two chili genotypes ('Plahi' and 'A-120'). Salinity stress significantly reduced fresh and dry weight, relative water contents, water use efficiency, leaf osmotic potential, glycine betaine (GB) contents, photosynthetic rate (A), transpiration rate (E), stomatal conductance (Ci), and chlorophyll contents of tested genotypes. Salinity stress significantly enhanced malondialdehyde (MDA) contents and activities of the enzymatic antioxidants such as superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD). In addition, increasing salinity levels significantly reduced the tissue phosphorus and potassium concentrations, while enhanced the tissue sodium and chloride concentrations. Genotype 'Plahi' had better growth and biochemical attributes compared to 'A-120'. Therefore, 'Plahi' is recommended for saline areas to improve chili production.
    MeSH terms: Capsicum/genetics*; Capsicum/growth & development; Chlorophyll/genetics; Genotype; Malondialdehyde/metabolism; Peroxidase/genetics; Potassium/metabolism; Sodium/metabolism; Sodium Chloride/adverse effects; Superoxide Dismutase/genetics; Water/chemistry; Reactive Oxygen Species/metabolism; Plant Leaves/genetics; Plant Leaves/growth & development; Salinity*; Salt-Tolerance/genetics*
  14. Shetty SS, Padam KSR, Hunter KD, Kudva A, Radhakrishnan R
    Arch Oral Biol, 2021 Oct 24;133:105294.
    PMID: 34735925 DOI: 10.1016/j.archoralbio.2021.105294
    OBJECTIVE: The objective of this review is to decipher the biological implications of the immune factors in the tumour microenvironment in oral cancer. The restoration of balance between tumour tolerance and tumour eradication by the host immune cells is critical to provide effective therapeutic strategies.

    DESIGN: The specific role of the stromal and the immune components in oral cancer was reviewed with a tailored search strategy using relevant keywords. The articles were retrieved from bibliometric databases indexed in PubMed, Scopus, and Embase. An in silico analysis was performed to identify potential drug candidates for immunotherapy, by accessing the Drug-Gene Interactions Database (DGIdb) using the rDGIdb package.

    RESULTS: There is compelling evidence for the role of the cellular and extracellular components of the tumour microenvironment in inducing immunosuppression and progression of oral cancer. The druggable candidates specifically targeting the immune system are a viable option in the treatment of oral cancer as they can regulate the tumour microenvironment.

    CONCLUSION: A complex interaction between the tumour and the immunological microenvironment influences the disease outcome in oral cancer. Targeting specific components of the immune system might be relevant, as immunotherapy may become the new standard of care for oral cancer.

  15. Alamoodi AH, Zaidan BB, Al-Masawa M, Taresh SM, Noman S, Ahmaro IYY, et al.
    Comput Biol Med, 2021 Dec;139:104957.
    PMID: 34735945 DOI: 10.1016/j.compbiomed.2021.104957
    A substantial impediment to widespread Coronavirus disease (COVID-19) vaccination is vaccine hesitancy. Many researchers across scientific disciplines have presented countless studies in favor of COVID-19 vaccination, but misinformation on social media could hinder vaccination efforts and increase vaccine hesitancy. Nevertheless, studying people's perceptions on social media to understand their sentiment presents a powerful medium for researchers to identify the causes of vaccine hesitancy and therefore develop appropriate public health messages and interventions. To the best of the authors' knowledge, previous studies have presented vaccine hesitancy in specific cases or within one scientific discipline (i.e., social, medical, and technological). No previous study has presented findings via sentiment analysis for multiple scientific disciplines as follows: (1) social, (2) medical, public health, and (3) technology sciences. Therefore, this research aimed to review and analyze articles related to different vaccine hesitancy cases in the last 11 years and understand the application of sentiment analysis on the most important literature findings. Articles were systematically searched in Web of Science, Scopus, PubMed, IEEEXplore, ScienceDirect, and Ovid from January 1, 2010, to July 2021. A total of 30 articles were selected on the basis of inclusion and exclusion criteria. These articles were formed into a taxonomy of literature, along with challenges, motivations, and recommendations for social, medical, and public health and technology sciences. Significant patterns were identified, and opportunities were promoted towards the understanding of this phenomenon.
    MeSH terms: Humans; Vaccination
  16. Wong HH, Pang NTP
    BMJ Case Rep, 2021 Oct 14;14(10).
    PMID: 34649855 DOI: 10.1136/bcr-2021-242333
    A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.
    MeSH terms: Female; Humans; Iodine Radioisotopes; Thyroid Neoplasms*; Thyroxine/therapeutic use
  17. Heffernan AJ, Mohd Sazlly Lim S, Lipman J, Roberts JA
    Anaesth Crit Care Pain Med, 2021 12;40(6):100970.
    PMID: 34728411 DOI: 10.1016/j.accpm.2021.100970
    Critically ill patients admitted to intensive care unit (ICU) with severe infections, or those who develop nosocomial infections, have poor outcomes with substantial morbidity and mortality. Such patients commonly have suboptimal antibiotic exposures at routinely used antibiotic doses related to an increased volume of distribution and altered clearance due to their underlying altered physiology. Furthermore, the use of extracorporeal devices such as renal replacement therapy and extracorporeal membrane oxygenation in these group of patients also has the potential to alter in vivo drug concentrations. Moreover, ICU patients are likely to be infected with less-susceptible pathogens. Therefore, one potential contributing cause to the poor outcomes observed in critically ill patients may be related to subtherapeutic antibiotic exposures. Newer concepts include the clinician considering optimised dosing based on a blood antibiotic exposure defined by pharmacokinetic modelling and therapeutic drug monitoring, combined with a knowledge of the antibiotic penetration into the site of infection, thereby achieving optimal bacterial killing. Such optimised dosing is likely to improve patient outcomes. The aim of this review is to highlight key aspects of antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in critically ill patients and provide a PK/PD approach to tailor antibiotic dosing to the individual patient.
  18. Vermunt J, Bragg F, Halsey J, Yang L, Chen Y, Guo Y, et al.
    PMID: 34728472 DOI: 10.1136/bmjdrc-2021-002495
    INTRODUCTION: We examined the associations between long-term usual random plasma glucose (RPG) levels and cause-specific mortality risks among adults without known diabetes in China.

    RESEARCH DESIGN AND METHODS: The China Kadoorie Biobank recruited 512,891 adults (59% women) aged 30-79 from 10 regions of China during 2004-2008. At baseline survey, and subsequent resurveys of a random subset of survivors, participants were interviewed and measurements collected, including on-site RPG testing. Cause of death was ascertained via linkage to local mortality registries. Cox regression yielded adjusted HR for all-cause and cause-specific mortality associated with usual levels of RPG.

    RESULTS: During median 11 years' follow-up, 37,214 deaths occurred among 452,993 participants without prior diagnosed diabetes or other chronic diseases. There were positive log-linear relationships between RPG and all-cause, cardiovascular disease (CVD) (n=14,209) and chronic kidney disease (CKD) (n=432) mortality down to usual RPG levels of at least 5.1 mmol/L. At RPG <11.1 mmol/L, each 1.0 mmol/L higher usual RPG was associated with adjusted HRs of 1.14 (95% CI 1.12 to 1.16), 1.16 (1.12 to 1.19) and 1.44 (1.22 to 1.70) for all-cause, CVD and CKD mortality, respectively. Usual RPG was positively associated with chronic liver disease (n=547; 1.45 (1.26 to 1.66)) and cancer (n=12,680; 1.12 (1.09 to 1.16)) mortality, but with comparably lower risks at baseline RPG ≥11.1 mmol/L. These associations persisted after excluding participants who developed diabetes during follow-up.

    CONCLUSIONS: Among Chinese adults without diabetes, higher RPG levels were associated with higher mortality risks from several major diseases, with no evidence of apparent thresholds below the cut-points for diabetes diagnosis.

    MeSH terms: Adult; Aged; Blood Glucose*; Cause of Death; China/epidemiology; Diabetes Mellitus*; Female; Humans; Male; Middle Aged; Prospective Studies
  19. Chin L, Choo PPL, Ng DC
    BMJ Case Rep, 2021 Nov 02;14(11).
    PMID: 34728517 DOI: 10.1136/bcr-2021-246970
    MeSH terms: Catheterization; Humans; Infant, Newborn; Parenteral Nutrition/adverse effects; Parenteral Nutrition, Total/adverse effects; Parenteral Nutrition Solutions
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