Browse publications by year: 2022

  1. Fulltext PD-L1 Expression in Endometrial Cancer and Its Association with Clinicopathological Features: A Systematic Review and Meta-Analysis
    Mamat Yusof MN, Chew KT, Kampan N, Abd Aziz NH, Md Zin RR, Tan GC, et al.
    Cancers (Basel), 2022 Aug 13;14(16).
    PMID: 36010904 DOI: 10.3390/cancers14163911
    Endometrial cancer (EC) is one of the most common malignancies of the female genital tract and its current treatment mainly relies on surgical removal of the tumour bulk, followed by adjuvant radiotherapy with or without chemotherapy/hormonal therapy. However, the outcomes of these approaches are often unsatisfactory and are associated with severe toxicity and a higher recurrence rate of the disease. Thus, more clinical research exploring novel medical intervention is needed. Involvement of the immune pathway in cancer has become important and the finding of a high positive expression of programmed cell death-ligand 1 (PD-L1) in EC may offer a better targeted therapeutic approach. Numerous studies on the PD-L1 role in EC have been conducted, but the results remained inconclusive. Hence, this systematic review was conducted to provide an update and robust analysis in order to determine the pooled prevalence of PD-L1 expression in EC and evaluate its association with clinicopathological features in different focuses of tumour cells (TC) and immune cells (IC). A comprehensive literature search was conducted using the PubMed, Web of Science, and Scopus databases. Twelve articles between 2016 and 2021 with 3023 EC cases met the inclusion criteria. The effect of PD-L1 expression on the outcome parameters was estimated by the odds ratios (ORs) with 95% confidence intervals (CIs) for each study. The pooled prevalence of PD-L1 was 34.26% and 51.39% in the tumour cell and immune cell, respectively, among women with EC. The PD-L1 expression was significantly associated with Stage III/IV disease (in both TC and IC) and correlated to the presence of lympho-vascular invasion in IC. However, the PD-L1 expression in TC was not associated with the age groups, histology types, myometrial invasion, and lympho-vascular invasion. In IC, PD-L1 expression was not associated with age group, histology type, and myometrial invasion. The meta-analysis survival outcomes of PD-L1 high expression had a significant association with worse OS in IC but not in TC.
  2. Fulltext Regional Anesthetic and Analgesic Techniques for Clavicle Fractures and Clavicle Surgeries: Part 1-A Scoping Review
    Lee CCM, Beh ZY, Lua CB, Peng K, Fathil SM, Hou JD, et al.
    Healthcare (Basel), 2022 Aug 07;10(8).
    PMID: 36011144 DOI: 10.3390/healthcare10081487
    Objective. Clavicle fractures are common injuries potentially associated with significant perioperative pain. However, this region's complex sensory innervation poses a challenge for regional anesthetic or analgesic (RA) techniques. We conducted this scoping review to summarize the current literature, particularly with regards to motor-sparing techniques. Methods. A scoping review was carried out in accordance with the Joanna Briggs Institute's framework. All articles describing the use of RA for clavicle fractures or surgery were included. PubMed®, Ovid MEDLINE®, EMBASE®, Scopus®, CINAHL®, and the Cochrane database were searched without language restrictions. Results. Database searches identified 845 articles, 44 of which were included in this review, with a combined patient total of 3161. We included all peer-reviewed publications containing clinical data and summarized the findings. Conclusions. Current evidence of RA techniques in clavicle surgery is heterogeneous, with different approaches used to overcome the overlapping sensory innervation. The literature largely comprises case reports/series, with several randomized controlled trials. Intermediate cervical plexus block is the regional technique of choice for clavicle surgery, and can provide reliable surgical anesthesia when combined with an interscalene block. Cervical plexus block can provide motor-sparing analgesia following clavicle surgery. Promising alternatives include the clavipectoral block, which is a novel motor-sparing regional technique. Further studies are required to determine the efficacy and safety of various techniques.
  3. Fulltext Graphene Oxide (GO): A Promising Nanomaterial against Infectious Diseases Caused by Multidrug-Resistant Bacteria
    Ng IMJ, Shamsi S
    Int J Mol Sci, 2022 Aug 13;23(16).
    PMID: 36012361 DOI: 10.3390/ijms23169096
    Infectious diseases are major threat due to it being the main cause of enormous morbidity and mortality in the world. Multidrug-resistant (MDR) bacteria put an additional burden of infection leading to inferior treatment by the antibiotics of the latest generations. The emergence and spread of MDR bacteria (so-called "superbugs"), due to mutations in the bacteria and overuse of antibiotics, should be considered a serious concern. Recently, the rapid advancement of nanoscience and nanotechnology has produced several antimicrobial nanoparticles. It has been suggested that nanoparticles rely on very different mechanisms of antibacterial activity when compared to antibiotics. Graphene-based nanomaterials are fast emerging as "two-dimensional wonder materials" due to their unique structure and excellent mechanical, optical and electrical properties and have been exploited in electronics and other fields. Emerging trends show that their exceptional properties can be exploited for biomedical applications, especially in drug delivery and tissue engineering. Moreover, graphene derivatives were found to have in vitro antibacterial properties. In the recent years, there have been many studies demonstrating the antibacterial effects of GO on various types of bacteria. In this review article, we will be focusing on the aforementioned studies, focusing on the mechanisms, difference between the studies, limitations and future directions.
    MeSH terms: Anti-Bacterial Agents/chemistry; Bacteria; Humans
  4. Fulltext Tunable Compact Metamaterial-Based Double-Negative/Near-Zero Index Resonator for 6G Terahertz Wireless Applications
    Musaed AA, Al-Bawri SS, Islam MT, Al-Gburi AJA, Singh MJ
    Materials (Basel), 2022 Aug 16;15(16).
    PMID: 36013745 DOI: 10.3390/ma15165608
    This paper introduces the tunability performance, concept, and analysis of a unique and miniaturized metamaterial (MTM) unit cell covering the upcoming 6G applications. The proposed metamaterial consists of two metallic star-shaped split-ring resonators (SRR). It has a line segment placed in the middle of the structure, which can feature tunable characteristics. The proposed design provides dual resonances of transmission coefficient S21 at 0.248 and 0.383 THz with a significant operating frequency span of 0.207-0.277 and 0.382-0.390 THz, respectively. Moreover, wide-range achievement, negative permittivity, double-negative (DNG) refractive index, and near-zero permeability characteristics have been exhibited in two (z and y) principal wave propagation axes. The resonance frequencies are selective and modified by adjusting the central slotted-strip line length. Furthermore, the metamaterial is constituted on a polyimide substrate while the overall dimensions are 160 × 160 μm2. A numerical simulation of the proposed design is executed in CST microwave studio and has been compared with advanced design software (ADS) to generate the proposed MTM's equivalent circuit, which exhibits a similar transmission coefficient (S21).
  5. Fulltext Regulation of Host Immune Response against Enterobacter cloacae Proteins via Computational mRNA Vaccine Design through Transcriptional Modification
    Naveed M, Jabeen K, Naz R, Mughal MS, Rabaan AA, Bakhrebah MA, et al.
    Microorganisms, 2022 Aug 10;10(8).
    PMID: 36014038 DOI: 10.3390/microorganisms10081621
    Enterobacter cloacae is mainly responsible for sepsis, urethritis, and respiratory tract infections. These bacteria may affect the transcription of the host and particularly their immune system by producing changes in their epigenetics. In the present study, four proteins of Enterobacter cloacae were used to predict the epitopes for the construction of an mRNA vaccine against Enterobacter cloacae infections. In order to generate cellular and humoral responses, various immunoinformatic-based approaches were used for developing the vaccine. The molecular docking analysis was performed for predicting the interaction among the chosen epitopes and corresponding MHC alleles. The vaccine was developed by combining epitopes (thirty-three total), which include the adjuvant Toll-like receptor-4 (TLR4). The constructed vaccine was analyzed and predicted to cover 99.2% of the global population. Additionally, in silico immunological modeling of the vaccination was also carried out. When it enters the cytoplasm of the human (host), the codon is optimized to generate the translated mRNA efficiently. Moreover, the peptide structures were analyzed and docked with TLR-3 and TLR-4. A dynamic simulation predicted the stability of the binding complex. The assumed construct was considered to be a potential candidate for a vaccine against Enterobacter cloacae infections. Hence, the proposed construct is suitable for in vitro analyses to validate its effectiveness.
  6. Fulltext Recent Advances in Non-Invasive Blood Pressure Monitoring and Prediction Using a Machine Learning Approach
    Ismail SNA, Nayan NA, Jaafar R, May Z
    Sensors (Basel), 2022 Aug 18;22(16).
    PMID: 36015956 DOI: 10.3390/s22166195
    Blood pressure (BP) monitoring can be performed either invasively via arterial catheterization or non-invasively through a cuff sphygmomanometer. However, for conscious individuals, traditional cuff-based BP monitoring devices are often uncomfortable, intermittent, and impractical for frequent measurements. Continuous and non-invasive BP (NIBP) monitoring is currently gaining attention in the human health monitoring area due to its promising potentials in assessing the health status of an individual, enabled by machine learning (ML), for various purposes such as early prediction of disease and intervention treatment. This review presents the development of a non-invasive BP measuring tool called sphygmomanometer in brief, summarizes state-of-the-art NIBP sensors, and identifies extended works on continuous NIBP monitoring using commercial devices. Moreover, the NIBP predictive techniques including pulse arrival time, pulse transit time, pulse wave velocity, and ML are elaborated on the basis of bio-signals acquisition from these sensors. Additionally, the different BP values (systolic BP, diastolic BP, mean arterial pressure) of the various ML models adopted in several reported studies are compared in terms of the international validation standards developed by the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS) for clinically-approved BP monitors. Finally, several challenges and possible solutions for the implementation and realization of continuous NIBP technology are addressed.
    MeSH terms: Machine Learning; Blood Pressure/physiology; Blood Pressure Determination*; Humans; Sphygmomanometers
  7. Fulltext Sanitation, water, energy use, and traffic volume affect environmental quality: Go-for-green developmental policies
    Khalil L, Abbas S, Hussain K, Zaman K, Iswan, Salamun H, et al.
    PLoS One, 2022;17(8):e0271017.
    PMID: 36026488 DOI: 10.1371/journal.pone.0271017
    Carbon emissions are primarily the result of human activity in urban areas. Inadequate sanitary facilities, contaminated drinking water, nonrenewable energy, and high traffic congestion have all impacted the natural ecosystem. Using data from 1975 to 2019, the study assessed the impact of the aforementioned variables on Pakistan's carbon emissions in light of this crucial fact. The ARDL cointegration method was used to estimate the short- and long-run parameter estimates. Urban sanitation challenges and energy consumption increase carbon emissions, which affects the natural environment by raising a country's carbon intensity. Economic expansion confirmed the inverted U-shaped relationship between carbon emissions and economic growth to verify the Environmental Kuznets Curve (EKC) hypothesis in the long run. In contrast, the monotonically rising function of carbon emissions provides evidence of the nation's economic development in the short run. Access to clean drinking water improves population health and encourages the purchase of eco-friendly products. The government must improve sanitation services and use renewable energy sources to enhance air quality.
    MeSH terms: Carbon; Carbon Dioxide; Humans; Sanitation*; Ecosystem; Economic Development; Policy; Renewable Energy; Drinking Water*
  8. Fulltext Efficacy of telemedicine for the management of cardiovascular disease: a systematic review and meta-analysis
    Kuan PX, Chan WK, Fern Ying DK, Rahman MAA, Peariasamy KM, Lai NM, et al.
    Lancet Digit Health, 2022 Sep;4(9):e676-e691.
    PMID: 36028290 DOI: 10.1016/S2589-7500(22)00124-8
    BACKGROUND: Telemedicine has been increasingly integrated into chronic disease management through remote patient monitoring and consultation, particularly during the COVID-19 pandemic. We did a systematic review and meta-analysis of studies reporting effectiveness of telemedicine interventions for the management of patients with cardiovascular conditions.

    METHODS: In this systematic review and meta-analysis, we searched PubMed, Scopus, and Cochrane Library from database inception to Jan 18, 2021. We included randomised controlled trials and observational or cohort studies that evaluated the effects of a telemedicine intervention on cardiovascular outcomes for people either at risk (primary prevention) of cardiovascular disease or with established (secondary prevention) cardiovascular disease, and, for the meta-analysis, we included studies that evaluated the effects of a telemedicine intervention on cardiovascular outcomes and risk factors. We excluded studies if there was no clear telemedicine intervention described or if cardiovascular or risk factor outcomes were not clearly reported in relation to the intervention. Two reviewers independently assessed and extracted data from trials and observational and cohort studies using a standardised template. Our primary outcome was cardiovascular-related mortality. We evaluated study quality using Cochrane risk-of-bias and Newcastle-Ottawa scales. The systematic review and the meta-analysis protocol was registered with PROSPERO (CRD42021221010) and the Malaysian National Medical Research Register (NMRR-20-2471-57236).

    FINDINGS: 72 studies, including 127 869 participants, met eligibility criteria, with 34 studies included in meta-analysis (n=13 269 with 6620 [50%] receiving telemedicine). Combined remote monitoring and consultation for patients with heart failure was associated with a reduced risk of cardiovascular-related mortality (risk ratio [RR] 0·83 [95% CI 0·70 to 0·99]; p=0·036) and hospitalisation for a cardiovascular cause (0·71 [0·58 to 0·87]; p=0·0002), mostly in studies with short-term follow-up. There was no effect of telemedicine on all-cause hospitalisation (1·02 [0·94 to 1·10]; p=0·71) or mortality (0·90 [0·77 to 1·06]; p=0·23) in these groups, and no benefits were observed with remote consultation in isolation. Small reductions were observed for systolic blood pressure (mean difference -3·59 [95% CI -5·35 to -1·83] mm Hg; p<0·0001) by remote monitoring and consultation in secondary prevention populations. Small reductions were also observed in body-mass index (mean difference -0·38 [-0·66 to -0·11] kg/m2; p=0·0064) by remote consultation in primary prevention settings.

    INTERPRETATION: Telemedicine including both remote disease monitoring and consultation might reduce short-term cardiovascular-related hospitalisation and mortality risk among patients with heart failure. Future research should evaluate the sustained effects of telemedicine interventions.

    FUNDING: The British Heart Foundation.

    MeSH terms: Cardiovascular Diseases*; Heart Failure*; Humans; Telemedicine*; Pandemics
  9. Fulltext Deciphering colorectal cancer immune microenvironment transcriptional landscape on single cell resolution - A role for immunotherapy
    Tieng FYF, Lee LH, Ab Mutalib NS
    Front Immunol, 2022;13:959705.
    PMID: 36032085 DOI: 10.3389/fimmu.2022.959705
    Single cell RNA sequencing (scRNA-seq) is a novel high-throughput technique that enables the investigation of a single cell's entire transcriptome. It elucidates intricate cellular networks and generates indices that will eventually enable the development of more targeted and personalized medications. The importance of scRNA-seq has been highlighted in complex biological systems such as cancer and the immune system, which exhibit significant cellular heterogeneity. Colorectal cancer (CRC) is the third most common type of cancer and the second leading cause of cancer-related death globally. Chemotherapy continues to be used to treat these patients. However, 5-FU has been utilized in chemotherapy regimens with oxaliplatin and irinotecan since the 1960s and is still used today. Additionally, chemotherapy-resistant metastatic CRCs with poor prognoses have been treated with immunotherapy employing monoclonal antibodies, immune checkpoint inhibitors, adoptive cell therapy and cancer vaccines. Personalized immunotherapy employing tumor-specific neoantigens allows for treating each patient as a distinct group. Sequencing and multi-omics approaches have helped us identify patients more precisely in the last decade. The introduction of modern methods and neoantigen-based immunotherapy may usher in a new era in treating CRC. The unmet goal is to better understand the cellular and molecular mechanisms that contribute to CRC pathogenesis and resistance to treatment, identify novel therapeutic targets, and make more stratified and informed treatment decisions using single cell approaches. This review summarizes current scRNA-seq utilization in CRC research, examining its potential utility in the development of precision immunotherapy for CRC.
    MeSH terms: Antibodies, Monoclonal; Humans; Immunologic Factors; Immunotherapy; Colorectal Neoplasms*; Cancer Vaccines*; Tumor Microenvironment
  10. Fulltext Nipah amidst Covid-19 Pandemic, another Re-Emerging Infectious Disease of Pandemic Potential - a Narrative Review
    Kaliappan A, Kaliappan V, Lakshmi JT, Raja S, Nikhat SS, Vidya MS, et al.
    Maedica (Bucur), 2022 Jun;17(2):464-470.
    PMID: 36032603 DOI: 10.26574/maedica.2022.17.2.464
    Introduction: Nipah virus (NiV) was reported for the first time from the Kampung Sungai Nipah village of Malaysia in 1998. Since then, there have been multiple outbreaks, all of them in South- and South-East Asia. According to the World Health Organization (WHO), up to 75% of Nipah infections were proven to be fatal. Nipah virus belongs to the group of Biosafety Level-4 pathogen associated with high case fatality rate (40-75%). Methodology:According to the PRISMA guidelines for 2020, we searched in four medical databases (PubMed, Google Scholar, EMBASE and Scopus) and selected relevant studies from the past twenty years till November 2021. Review:Nipah virus was first detected in Malaysia's Kampung Sungai Nipah in 1998. By May 1999, the Malaysia Ministry of Health in association with the Centers for Disease Control (CDC) reported a total of 258 cases with a case fatality rate of almost 40%. Nipah in Kozhikode:Experts from the Pune Institute and Bhopal's National Institute of High Security Animal Diseases had collected Bat samples from Pazhoor in Chathamangalam gram panchayat (where a 12-year-old died due to Nipah infection on September 5 carried antibodies of the virus). All Indian outbreaks have seen person-to-person transmission. The virus found in Kerala differed from those two variants in terms of genetic structure. It also differed by 1.96% from the Bangladesh variant. The difference with the Malaysian variant was 8.42%. While PCR is the most sensitive technique for diagnosing active NiV infection, NiV-specific IgM ELISA offers a serological option when PCR is not available. Conclusions:Understanding the fruit bat ecology, NiV illness seasonality, and the transmission risk of various intermediate species requires a One Health approach. The danger of reintroduction into animal or human populations cannot be handled without a thorough understanding of the wildlife reservoir.
  11. Fulltext Management of dysphagia and gastroparesis in Parkinson's disease in real-world clinical practice - Balancing pharmacological and non-pharmacological approaches
    Bhidayasiri R, Phuenpathom W, Tan AH, Leta V, Phumphid S, Chaudhuri KR, et al.
    Front Aging Neurosci, 2022;14:979826.
    PMID: 36034128 DOI: 10.3389/fnagi.2022.979826
    Gastrointestinal (GI) issues are commonly experienced by patients with Parkinson's disease (PD). Those that affect the lower GI tract, such as constipation, are the most frequently reported GI problems among patients with PD. Upper GI issues, such as swallowing dysfunction (dysphagia) and delayed gastric emptying (gastroparesis), are also common in PD but are less well recognized by both patients and clinicians and, therefore, often overlooked. These GI issues may also be perceived by the healthcare team as less of a priority than management of PD motor symptoms. However, if left untreated, both dysphagia and gastroparesis can have a significant impact on the quality of life of patients with PD and on the effectiveness on oral PD medications, with negative consequences for motor control. Holistic management of PD should therefore include timely and effective management of upper GI issues by utilizing both non-pharmacological and pharmacological approaches. This dual approach is key as many pharmacological strategies have limited efficacy in this setting, so non-pharmacological approaches are often the best option. Although a multidisciplinary approach to the management of GI issues in PD is ideal, resource constraints may mean this is not always feasible. In 'real-world' practice, neurologists and PD care teams often need to make initial assessments and treatment or referral recommendations for their patients with PD who are experiencing these problems. To provide guidance in these cases, this article reviews the published evidence for diagnostic and therapeutic management of dysphagia and gastroparesis, including recommendations for timely and appropriate referral to GI specialists when needed and guidance on the development of an effective management plan.
  12. Fulltext Potential of histone deacetylase inhibitors in the control and regulation of prostate, breast and ovarian cancer
    Pramanik SD, Kumar Halder A, Mukherjee U, Kumar D, Dey YN, R M
    Front Chem, 2022;10:948217.
    PMID: 36034650 DOI: 10.3389/fchem.2022.948217
    Histone deacetylases (HDACs) are enzymes that play a role in chromatin remodeling and epigenetics. They belong to a specific category of enzymes that eliminate the acetyl part of the histones' -N-acetyl lysine, causing the histones to be wrapped compactly around DNA. Numerous biological processes rely on HDACs, including cell proliferation and differentiation, angiogenesis, metastasis, gene regulation, and transcription. Epigenetic changes, specifically increased expression and activity of HDACs, are commonly detected in cancer. As a result, HDACi could be used to develop anticancer drugs. Although preclinical outcomes with HDACs as monotherapy have been promising clinical trials have had mixed results and limited success. In both preclinical and clinical trials, however, combination therapy with different anticancer medicines has proved to have synergistic effects. Furthermore, these combinations improved efficacy, decreased tumor resistance to therapy, and decreased toxicity. In the present review, the detailed modes of action, classification of HDACs, and their correlation with different cancers like prostate, breast, and ovarian cancer were discussed. Further, the different cell signaling pathways and the structure-activity relationship and pharmaco-toxicological properties of the HDACi, and their synergistic effects with other anticancer drugs observed in recent preclinical and clinical studies used in combination therapy were discussed for prostate, breast, and ovarian cancer treatment.
  13. Fulltext Tacrine Derivatives in Neurological Disorders: Focus on Molecular Mechanisms and Neurotherapeutic Potential
    Mitra S, Muni M, Shawon NJ, Das R, Emran TB, Sharma R, et al.
    Oxid Med Cell Longev, 2022;2022:7252882.
    PMID: 36035218 DOI: 10.1155/2022/7252882
    Tacrine is a drug used in the treatment of Alzheimer's disease as a cognitive enhancer and inhibitor of the enzyme acetylcholinesterase (AChE). However, its clinical application has been restricted due to its poor therapeutic efficacy and high prevalence of detrimental effects. An attempt was made to understand the molecular mechanisms that underlie tacrine and its analogues influence over neurotherapeutic activity by focusing on modulation of neurogenesis, neuroinflammation, endoplasmic reticulum stress, apoptosis, and regulatory role in gene and protein expression, energy metabolism, Ca2+ homeostasis modulation, and osmotic regulation. Regardless of this, analogues of tacrine are considered as a model inhibitor of cholinesterase in the therapy of Alzheimer's disease. The variety both in structural make-up and biological functions of these substances is the main appeal for researchers' interest in them. A new paradigm for treating neurological diseases is presented in this review, which includes treatment strategies for Alzheimer's disease, as well as other neurological disorders like Parkinson's disease and the synthesis and biological properties of newly identified versatile tacrine analogues and hybrids. We have also shown that these analogues may have therapeutic promise in the treatment of neurological diseases in a variety of experimental systems.
    MeSH terms: Acetylcholinesterase; Alzheimer Disease*; Cholinesterase Inhibitors; Humans; Structure-Activity Relationship; Tacrine*
  14. Fulltext Acceptability and Willingness of UAE Residents to Use OTC Vending Machines to Deliver Self-Testing Kits for COVID-19 and the Implications
    Jairoun AA, Al Hemyari SS, Abdulla NM, Shahwan M, Hashim Jaber Bilal F, Al-Tamimi SK, et al.
    J Multidiscip Healthc, 2022;15:1759-1770.
    PMID: 36039076 DOI: 10.2147/JMDH.S370441
    PURPOSE: Self-testing kits for SARS-CoV-2 appear effective, practical, safe and reliable as well as helping patients with mild-to-moderate symptoms to be successfully managed at home without going to hospital. As a result, ease pressures on hospitals. OTC vending machines offer the potential for SARS-CoV-2 self-testing kits alongside making available OTC treatments to alleviate the symptoms of COVID-19. As a result, providing confidentiality alongside ease of use in case people do not want their status broad casted. Consequently, there was a need to assess the acceptability and willingness regarding the availability of OTC vending machines to dispense self-testing kits for SARS-CoV-2 among UAE residents to provide future direction.

    PATIENTS AND METHODS: A cross-sectional survey using a designed questionnaire was based on previous research and expert input and pilot tested. All items in the final questionnaire were seen as acceptable with a satisfactory content validity. A purposive sampling strategy was used in the principal study by primarily sending a link to the questionnaire to UAE universities via Facebook and WhatsApp.

    RESULTS: A total of 876 respondents participated in the study and completed the whole questionnaire. Most participants were female (63%), Arabic origin (42%) and holding a bachelor's degree (84.5%). There was high acceptability and willingness to use self-testing kits (87.2%), with 88.6% of respondents believing OTC vending machines would be beneficial for patients with actual or suspected SARS-CoV-2. Gender, nationality, educational level, employment status, having relatives infected with SARS-CoV-2 and being vaccinated were significantly associated with attitudes towards the self-testing kits. Recognised barriers include their potential costs, ease of access and help for those who cannot read the instructions.

    CONCLUSION: Overall, there was high acceptability and willingness to use OTC vending machines to deliver self-testing kits for SARS-CoV-2 among the surveyed participants. Key barriers will need to be addressed to enhance their use.

  15. Fulltext Long COVID and its associated factors among COVID survivors in the community from a middle-income country-An online cross-sectional study
    Moy FM, Hairi NN, Lim ERJ, Bulgiba A
    PLoS One, 2022;17(8):e0273364.
    PMID: 36040960 DOI: 10.1371/journal.pone.0273364
    Patients with COVID-19 usually recover and return to normal health, however some patients may have symptoms that last for weeks or even months after recovery. This persistent state of ill health is known as Long COVID if it continues for more than three months and are not explained by an alternative diagnosis. Long Covid has been overlooked, especially in the low- and middle-income countries. Therefore, we conducted an online survey among the COVID-19 survivors in the community to explore their Long COVID symptoms, factors associated with Long COVID and how Long COVID affected their work. A total of 732 COVID-19 survivors responded, with 56% were without or with mild symptoms during their acute COVID-19 conditions. One in five COVID-19 survivors reported of experiencing Long COVID. The most commonly reported symptoms were fatigue, brain fog, depression, anxiety and insomnia. Females had 58% higher odds (95% CI: 1.02, 2.45) of experiencing Long COVID. Patients with moderate and severe levels of acute COVID-19 symptoms had OR of 3.01 (95% CI: 1.21, 7.47) and 3.62 (95% CI: 1.31, 10.03) respectively for Long COVID. Recognition of Long COVID and its associated factors is important in planning prevention, rehabilitation, clinical management to improve recovery from COVID-19.
    MeSH terms: Anxiety/epidemiology; Cross-Sectional Studies; Depression/epidemiology; Female; Humans; Survivors; Pandemics
  16. Fulltext Pickering emulsion stabilized by palm-pressed fiber cellulose nanocrystal extracted by acid hydrolysis-assisted high pressure homogenization
    Ng SW, Chong WT, Soo YT, Tang TK, Ab Karim NA, Phuah ET, et al.
    PLoS One, 2022;17(8):e0271512.
    PMID: 36044467 DOI: 10.1371/journal.pone.0271512
    Palm pressed fibre (PPF) is a lignocellulose biomass generated from palm oil mill that is rich in cellulose. The present work aimed to combine acid hydrolysis followed by high-pressure homogenisation (HPH) to produce nanocrystal cellulose (CNC) with enhanced physicochemical properties from PPF. PPF was alkaline treated, bleached, acid hydrolysed and homogenised under high pressure condition to prepare CNC. The effects of homogenisation pressure (10, 30, 50, 70 MPa) and cycles (1, 3, 5, 7) on the particle size, zeta potential and rheological properties of CNC produced were investigated. HPH was capable of producing CNC with better stability. Results revealed that utilizing 1 cycle of homogenisation at a pressure of 50 MPa resulted in CNC with the smallest dimension, highest aspect ratio, moderate viscosity and exceptionally high zeta potential. Subsequently, 0.15% (CNC 0.15 -PE) and 0.30% (CNC 0.30 -PE) of CNC was used to stabilise oil-in-water emulsions and their stability was evaluated against different pH, temperature and ionic strength. All the CNC-stabilised emulsions demonstrated good thermal stability. CNC 0.30 -PE exhibited larger droplets but higher stability than CNC 0.15 -PE. In short, CNC with gel like structure has a promising potential to serve as a natural Pickering emulsifier to stabilise oil-in-water emulsion in various food applications.
    MeSH terms: Dietary Fiber; Emulsions/chemistry; Hydrolysis; Water/chemistry
  17. Fulltext Acute lymphoblastic leukemia with clonal evolution due to delay in chemotherapy: A report of a case
    Haidary AM, Saadaat R, Abdul-Ghafar J, Rahmani S, Noor S, Noor S, et al.
    EJHaem, 2022 Aug;3(3):1013-1017.
    PMID: 36051042 DOI: 10.1002/jha2.483
    Clonal evolution in acute leukemias is one of the most important factors that leads to therapeutic failure and disease relapse. Delay in therapeutic intervention is one of the reasons that leads toward clonal evolution. In this report, we present a case of acute lymphoblastic leukemia in which therapeutic delay resulted in clonal evolution that was detected by conventional karyotyping and was responsible for non-responsiveness of the disease to conventional chemotherapy. A 17-year-old boy presented with generalized body aches, rapidly progressive pallor and lethargy. Bone marrow analysis was consistent with the diagnosis of B-cell ALL. Karyotypic analysis revealed 46, XY male karyotype. The patient left the hospital due to financial reasons and after 40 days came back to the hospital. Repeated bone marrow analysis including cytogenetic studies revealed presence of three different clones of blast cells: one clone showed 46, XY with del(9p) and t (11;14), second clone showed 46, XY with del(7q) and del(9p), and the third clone showed 46, XY normal karyotype. The patient did not respond to chemotherapy and died within 1 week of induction chemotherapy (HyperCVAD-A). Timely diagnosis and institution of chemotherapy in acute leukemias patients is the key to prevent clonal evolution and thus resistance of the disease to therapeutic interventions.
  18. Fulltext Pathomechanisms of bone loss in rheumatoid arthritis
    Sakthiswary R, Uma Veshaaliini R, Chin KY, Das S, Sirasanagandla SR
    Front Med (Lausanne), 2022;9:962969.
    PMID: 36059831 DOI: 10.3389/fmed.2022.962969
    Rheumatoid arthritis (RA) is an autoimmune disease, in which the inflammatory processes involve the skeletal system and there is marked destruction of the bones and the surrounding structures. In this review, we discuss the current concepts of osteoimmunology in RA, which represent the molecular crosstalk between the immune and skeletal systems, resulting in the disruption of bone remodeling. Bone loss in RA can be focal or generalized, leading to secondary osteoporosis. We have summarized the recent studies of bone loss in RA, which focused on the molecular aspects, such as cytokines, autoantibodies, receptor activator of nuclear kappa-β ligand (RANKL) and osteoprotegerin (OPG). Apart from the above molecules, the role of aryl hydrocarbon receptor (Ahr), which is a potential key mediator in this process through the generation of the Th17 cells, is discussed. Hence, this review highlights the key insights into molecular mechanisms of bone loss in RA.
  19. Fulltext Hybrid of deep learning and exponential smoothing for enhancing crime forecasting accuracy
    Butt UM, Letchmunan S, Hassan FH, Koh TW
    PLoS One, 2022;17(9):e0274172.
    PMID: 36070317 DOI: 10.1371/journal.pone.0274172
    The continued urbanization poses several challenges for law enforcement agencies to ensure a safe and secure environment. Countries are spending a substantial amount of their budgets to control and prevent crime. However, limited efforts have been made in the crime prediction area due to the deficiency of spatiotemporal crime data. Several machine learning, deep learning, and time series analysis techniques are exploited, but accuracy issues prevail. Thus, this study proposed a Bidirectional Long Short Term Memory (Bi-LSTM) and Exponential Smoothing (ES) hybrid for crime forecasting. The proposed technique is evaluated using New York City crime data from 2010-2017. The proposed approach outperformed as compared to state-of-the-art Seasonal Autoregressive Integrated Moving Averages (SARIMA) with low Mean Absolute Percentage Error (MAPE) (0.3738, 0.3891, 0.3433,0.3964), Root Mean Square Error (RMSE)(13.146, 13.669, 13.104, 13.77), and Mean Absolute Error (MAE) (9.837, 10.896, 10.598, 10.721). Therefore, the proposed technique can help law enforcement agencies to prevent and control crime by forecasting crime patterns.
    MeSH terms: Crime; Data Collection; Forecasting; Models, Statistical*
  20. Fulltext A study of the crystal structures, supra-molecular patterns and Hirshfeld surfaces of bromide salts of hypoxanthine and xanthine
    Sathya U, Nirmalram JS, Gomathi S, Dhivya D, Jegan Jennifer S, Abdul Razak I
    Acta Crystallogr E Crystallogr Commun, 2022 Jun 01;78(Pt 6):652-659.
    PMID: 36072131 DOI: 10.1107/S2056989022005278
    Two new crystalline salts, namely, hypoxanthinium bromide monohydrate, C5H5N4O+·Br-·H2O (I) and xanthinium bromide monohydrate, C5H5N4O2 +·Br-·H2O (II), were synthesized and characterized by single-crystal X-ray diffraction technique and Hirshfeld surface analysis. The hypoxanthinium and xanthinium cations in salts I and II are both in the oxo-N(9)-H tautomeric form. The crystal packing of the two salts is governed predominantly by N-H⋯O, N-H⋯Br, C-H⋯Br and O-H⋯Br inter-actions described by R 2 3(9) and R 2 2(8) synthons. The crystal packing is also consolidated by carbon-yl⋯π inter-actions between symmetry-related hypoxanthinium (HX+ ) cations in salt I and xanthinium cations (XA+ ) in salt II. The combination of all these inter-actions leads to the formation of wave- and staircase-like architectures in salts I and II, respectively. The largest contributions to the overall Hirshfeld surface are from Br⋯H/H⋯Br contacts (22.3% in I and 25.4% in II) .
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