Browse publications by year: 2023

  1. Selvakumar K, Lee Fan T, Chai Nien F, Hou Kit M
    PLoS One, 2023;18(9):e0291534.
    PMID: 37747888 DOI: 10.1371/journal.pone.0291534
    BACKGROUND: Migraine is a primary neurological headache. Treatment of this condition includes medications; however, these medications, when given for a longer duration, can have side effects. If migraine is left untreated or undiagnosed, it is reported that around 2.5% of individuals with migraine may develop to have a chronic condition. This study aims to analyse the preliminary effectiveness of aerobic training on migraine pain level, sleep quality, quality of life, and resting-state brain waves among university students with migraine symptoms.

    METHODOLOGY: 88 university students with migraine symptoms are the target participants. 4 of 5 on the Migraine Screen Questionnaire, 5 of 7 on the International Classification of Headache Disorders 3rd edition (ICHD-3), and both genders aged 18-40 years will be included. The participants with a score of more than or equal to 5 on the visual aura rating scale, diagnosed with a secondary headache, pregnancy, medication for neurological and cardiorespiratory conditions, and unwilling to participate will be excluded. Based on the disability questionnaire, the participants will be randomly assigned to either of the three groups. The primary outcome is resting-state electroencephalography (EEG) brain, and the secondary outcomes are sleep quality, quality of life, and migraine pain level. The post-test assessments will be performed at week 6.

    RESULT: After the primary EEG analysis using MATLAB, the amplitude, frequency, frequency band ratio, and power spectrum density will be analysed. Mixed design analysis and intention-to-treat analysis will be used to assess the efficacy of aerobic training.

    DISCUSSION: Migraines can be unpredictable, sometimes occurring without symptoms. If underdiagnosed or over-looked, it encompasses a serious of long-term effects. Hence with appropriate intervention, the symptoms can be prevented from worsening. But there is an unmet need for evidence-based non-pharmacological approaches to complement pharmacotherapy in migraine prevention. Moreover, an exercise intervention may be more suitable for people with migraine considering their tendency toward inactivity. Although some studies developed exercise programs for untrained patients with migraine, the outcome was primarily in terms of exercise capacity rather than the primary characteristics and secondary brain wave/ sleep quality changes, indicating the need for this study.

    MeSH terms: Female; Headache; Humans; Male; Pilot Projects; Quality of Life*; Students; Universities; Randomized Controlled Trials as Topic; Treatment Outcome
  2. Tan YK, Siau CS, Chan LF, Kõlves K, Zhang J, Ho MC, et al.
    Asian J Psychiatr, 2023 Nov;89:103772.
    PMID: 37748229 DOI: 10.1016/j.ajp.2023.103772
    This cross-sectional study aimed to validate the Life Events Checklist for DSM-5 (LEC-5) among Malaysian undergraduates (N = 500; mean age = 21.66 ± 1.57), of which 90.4% had ever experienced a lifetime traumatic event. Cronbach's alpha of .87 (95% CI [.86, .89]) and McDonald's omega of .89 (95% CI [.89, .93]) indicated good reliability. Confirmatory factor analysis based on a six-factor structure showed the best fit. The measurement invariance showed that the six-factor structure was similar across sexes. Therefore, the Malay LEC-5 is a valid and reliable instrument to screen for traumatic events among Malaysian undergraduates.
    MeSH terms: Cross-Sectional Studies; Humans; Life Change Events*; Malaysia; Students*; Universities; Reproducibility of Results; Asian Continental Ancestry Group*; Young Adult; Checklist*
  3. Bhat AA, Goyal A, Thapa R, Almalki WH, Kazmi I, Alzarea SI, et al.
    Cytokine, 2023 Nov;171:156376.
    PMID: 37748333 DOI: 10.1016/j.cyto.2023.156376
    Cancer involves cells' abnormal growth and ability to invade or metastasize to different body parts. Cancerous cells can divide uncontrollably and spread to other areas through the lymphatic or circulatory systems. Tumors form when malignant cells clump together in an uncontrolled manner. In this context, the cytokine interferon-gamma (IFN-γ) is crucial in regulating immunological responses, particularly malignancy. While IFN-γ is well-known for its potent anti-tumor effects by activating type 1 immunity, recent research has revealed its ability to suppress type 2 immunity, associated with allergy and inflammatory responses. This review aims to elucidate the intricate function of IFN-γ in inhibiting type 2 immune responses to cancer. We explore how IFN-γ influences the development and function of immune cells involved in type 2 immunity, such as mast cells, eosinophils, and T-helper 2 (Th2) cells. Additionally, we investigate the impact of IFN-mediated reduction of type 2 immunity on tumor development, metastasis, and the response to immunotherapeutic interventions. To develop successful cancer immunotherapies, it is crucial to comprehend the complex interplay between type 2 and type 1 immune response and the regulatory role of IFN-γ. This understanding holds tremendous promise for the development of innovative treatment approaches that harness the abilities of both immune response types to combat cancer. However, unraveling the intricate interplay between IFN-γ and type 2 immunity in the tumor microenvironment will be essential for achieving this goal.
  4. Ansari JA, Malik JA, Ahmed S, Bhat FA, Khanam A, Mir SA, et al.
    Pharmacology, 2023;108(6):504-520.
    PMID: 37748454 DOI: 10.1159/000531802
    BACKGROUND: The development of breast cancer (BC) and how it responds to treatment have both been linked to the involvement of inflammation. Chronic inflammation is critical in carcinogenesis, leading to elevated DNA damage, impaired DNA repair machinery, cell growth, apoptosis, angiogenesis, and invasion. Studies have found several targets that selectively modulate inflammation in cancer, limit BC's growth, and boost treatment effectiveness. Drug resistance and the absence of efficient therapeutics for metastatic and triple-negative BC contribute to the poor outlook of BC patients.

    SUMMARY: To treat BC, small-molecule inhibitors, phytomedicines, and nanoparticles are conjugated to attenuate BC signaling pathways. Due to their numerous target mechanisms and strong safety records, phytomedicines and nanomedicines have received much attention in studies examining their prospects as anti-BC agents by such unfulfilled demands.

    KEY MESSAGES: The processes involved in the affiliation across the progression of tumors and the spread of inflammation are highlighted in this review. Furthermore, we included many drugs now undergoing clinical trials that target cancer-mediated inflammatory pathways, cutting-edge nanotechnology-derived delivery systems, and a variety of phytomedicines that presently address BC.

    MeSH terms: Female; Humans; Inflammation/drug therapy; Signal Transduction; Nanomedicine
  5. Dian ND, Muhammad AB, Azman EN, Eddie NA, Azmi NI, Yee VCT, et al.
    Am J Trop Med Hyg, 2023 Nov 01;109(5):1081-1085.
    PMID: 37748768 DOI: 10.4269/ajtmh.23-0184
    Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the Plasmodium cytochrome c oxidase subunit III (cox3) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of Plasmodium knowlesi mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40 years old (P = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other P. knowlesi isolates. These findings indicate low submicroscopic P. knowlesi infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.
    MeSH terms: Adult; Cross-Sectional Studies; Humans; Malaysia/epidemiology; Polymerase Chain Reaction; Young Adult
  6. McCoy D, Roberts S, Daoudi S, Kennedy J
    BMJ Glob Health, 2023 Sep;8(9).
    PMID: 37748796 DOI: 10.1136/bmjgh-2023-013067
    The past four decades have seen a steady rise of references to 'security' by health academics, policy-makers and practitioners, particularly in relation to threats posed by infectious disease pandemics. Yet, despite an increasingly dominant health security discourse, the many different ways in which health and security issues and actors intersect have remained largely unassessed and unpacked in current critical global health scholarship. This paper discusses the emerging and growing health-security nexus in the wake of COVID-19 and the international focus on global health security. In recognising the contested and fluid concept of health security, this paper presents two contrasting approaches to health security: neocolonial health security and universal health security. Building from this analysis, we present a novel heuristic that delineates the multiple intersections and entanglements between health and security actors and agendas to broaden our conceptualisation of global health security configurations and practices and to highlight the potential for harmful unintended consequences, the erosion of global health norms and values, and the risk of health actors being co-opted by the security sector.
    MeSH terms: Humans; Politics; Global Health; Pandemics
  7. Raffali MAA, Boon Cong B, Muhammad SF, Che Hassan HH
    BMJ Case Rep, 2023 Sep 25;16(9).
    PMID: 37748814 DOI: 10.1136/bcr-2023-255396
    A man in his 20s with underlying chemorefractory primary T-lymphoblastic lymphoma and hypereosinophilia developed acute chest pain in the ward after readmission for disease progression. ECG showed widespread ST depression and serum troponin was markedly elevated. Transthoracic echocardiography showed diffused thrombus deposition with preserved ejection fraction consistent with eosinophilic myocarditis. The patient ultimately succumbed to the disease, after complications with severe hospital-acquired pneumonia.
    MeSH terms: Humans; Lymphoma, Non-Hodgkin*; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma*; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma*
  8. Buzayan MM, Elkezza AH, Ahmad SF, Mohd Salleh N, Sivakumar I
    J Prosthet Dent, 2023 Sep 23.
    PMID: 37748996 DOI: 10.1016/j.prosdent.2023.08.027
    STATEMENT OF PROBLEM: The fabrication of facial prostheses is complicated and time-consuming because of the need for accurate impressions of the facial defects and surrounding tissues. Inaccuracies can arise from soft-tissue compression, involuntary patient movements, and insufficient support for the impression material. Various 3-dimensional (3D) imaging and scanning techniques, including photogrammetry, have been introduced, but their accuracy remains insufficiently evaluated.

    PURPOSE: The purpose of this in vitro study was to evaluate and compare the accuracy of 3D digital casts generated by 4 photogrammetry software programs (Agisoft Metashape, 3DF Zephyr, Meshroom, and Polycam) and casts from 2 conventional impression materials (alginate and polyvinyl siloxane [PVS]) for the fabrication of nasal maxillofacial prostheses.

    MATERIAL AND METHODS: A stone cast of a patient's nose was used as the basis for generating a reference digital 3D cast and another 54 test 3D casts. The reference cast was created by scanning the stone cast using a FARO Optor Lab 3D scanner. The 54 test 3D casts were generated and divided into 6 test groups as follows: Agisoft group: 9 3D casts generated using Agisoft Metashape, a commercial personal computer (PC) software program; 3DF Zephyr group: 9 3D casts generated using 3DF Zephyr, a commercial PC software program; Meshroom group: 9 3D casts generated using Meshroom, a free PC software program; Polycam group: 9 3D casts generated using the Polycam, a commercial Android cloud application; PVS group: 9 3D casts generated indirectly by 3D scanning a gypsum cast made from a polyvinyl siloxane (PVS) impression of the stone nose cast; and Alginate group: 9 3D casts generated indirectly by scanning a master cast made using alginate impressions of the stone nose cast. Deviation measurements of the produced specimens were analyzed using the Geomagic Control X software program, and statistical comparisons were performed employing the Kruskal-Wallis test (α=.05).

    RESULTS: The results showed that the 3DF Zephyr group had the smallest deviation measurements (median: 0.057 mm ±0.012) among the 4 photogrammetry software programs, while the alginate impression group had the largest deviations (median: 0.151 mm ±0.094) of the 2 conventional impression materials. Significant differences were observed among the 4 photogrammetry software programs and the 2 conventional impression materials (H=39.41, df=5, P.05).

    CONCLUSIONS: Photogrammetry software programs, specifically Agisoft Metashape and 3DF Zephyr, demonstrated better accuracy than conventional impression materials in creating nasal digital casts. Photogrammetry has the potential to improve workflow and reduce patient discomfort during the fabrication of maxillofacial prostheses. Further research is needed to validate these findings in clinical settings.

  9. Qamruzzaman M
    Environ Sci Pollut Res Int, 2023 Oct;30(49):108107-108134.
    PMID: 37749463 DOI: 10.1007/s11356-023-29825-7
    This study aims to assess the effects of clean energy, environmental sustainability, and inward FDI on tourism growth in Malaysia data spanning from 1990 to 2019. The study employs the Bayer-Hanck cointegration test, ARDL bound testing, nonlinear ARDL, Toda-Yamamoto causality, and Fourier TY causality test. Additionally, dynamic OLS, fully-modified OLS, and CCR are employed to ensure robust coefficient testing. The study's findings demonstrate a noteworthy and favorable correlation between the utilization of clean energy, the advancement of tourism, and the subsequent rise in inward foreign direct investment (FDI). Moreover, the NARDL model reveals the complex interplay between adopting clean energy, environmental sustainability, and tourism growth. The causality tests, such as Fourier TY, offer valuable insights into the direction and intensity of the identified causal relationships. The study's implications are diverse and complex. Firstly, it highlights the crucial significance of clean energy as a catalyst for Malaysia's sustainable tourism development. Furthermore, this research offers valuable insights for policymakers and industry stakeholders seeking to leverage the economic and environmental advantages of integrating clean energy. Finally, this study contributes to the growing body of literature on the interplay between clean energy, tourism, and inward foreign direct investment (FDI), establishing a solid basis for future research in comparable settings. In conclusion, this research contributes to the enhanced comprehension of the intricate relationship between clean energy, the expansion of tourism, and inward foreign direct investment (FDI) in Malaysia. The utilization of various methodologies provides a comprehensive viewpoint on the dynamic relationships, emphasizing the potential for promoting sustainable development while simultaneously achieving economic benefits.
  10. Lin GSS, Ng YS, Ghani NRNA, Chua KH
    BMC Oral Health, 2023 Sep 25;23(1):690.
    PMID: 37749537 DOI: 10.1186/s12903-023-03389-x
    BACKGROUND: The integration of artificial intelligence (AI) in dentistry has the potential to revolutionise the field of dental technologies. However, dental technicians' views on the use of AI in dental technology are still sparse in the literature. This qualitative study aimed to explore the perceptions of dental technicians regarding the use of AI in their dental laboratory practice.

    METHODS: Twelve dental technicians with at least five years of professional experience and currently working in Malaysia agreed to participate in the one-to-one in-depth online interviews. Interviews were recorded, transcribed verbatim and translated. Thematic analysis was conducted to identify patterns, themes, and categories within the interview transcripts.

    RESULTS: The analysis revealed two key themes: "Perceived Benefits of AI" and "Concerns and Challenges". Dental technicians recognised the enhanced efficiency, productivity, accuracy, and precision that AI can bring to dental laboratories. They also acknowledged the streamlined workflow and improved communication facilitated by AI systems. However, concerns were raised regarding job security, professional identity, ethical considerations, and the need for adequate training and support.

    CONCLUSION: This research sheds light on the potential benefits and challenges associated with the integration of AI in dental laboratory practices. Understanding these perceptions and addressing the challenges can support the effective integration of AI in dental laboratories and contribute to the growing body of literature on AI in healthcare.

    MeSH terms: Artificial Intelligence*; Communication; Delivery of Health Care; Dental Technicians*; Humans; Qualitative Research
  11. Raee P, Tan SC, Najafi S, Zandsalimi F, Low TY, Aghamiri S, et al.
    Reprod Biol Endocrinol, 2023 Sep 26;21(1):88.
    PMID: 37749573 DOI: 10.1186/s12958-023-01134-1
    Autophagy is a highly conserved, lysosome-dependent biological mechanism involved in the degradation and recycling of cellular components. There is growing evidence that autophagy is related to male reproductive biology, particularly spermatogenic and endocrinologic processes closely associated with male sexual and reproductive health. In recent decades, problems such as decreasing sperm count, erectile dysfunction, and infertility have worsened. In addition, reproductive health is closely related to overall health and comorbidity in aging men. In this review, we will outline the role of autophagy as a new player in aging male reproductive dysfunction and prostate cancer. We first provide an overview of the mechanisms of autophagy and its role in regulating male reproductive cells. We then focus on the link between autophagy and aging-related diseases. This is followed by a discussion of therapeutic strategies targeting autophagy before we end with limitations of current studies and suggestions for future developments in the field.
    MeSH terms: Aging; Autophagy; Humans; Erectile Dysfunction*; Male; Prostatic Neoplasms*; Semen
  12. Sullivan L, Ho JN, Lee YZ, Khalid GM, Sandhu AK, Meilianti S, et al.
    J Pharm Policy Pract, 2023 Sep 25;16(1):105.
    PMID: 37749646 DOI: 10.1186/s40545-023-00620-6
    BACKGROUND: Professional organisations exist as international or national organisations, with each country establishing at least one national professional association. There remains a knowledge gap about factors that influence professional organisational involvement of pharmacists and pharmaceutical scientists. This study aims to explore the motivators and barriers of pharmacy professionals holding organisation membership from a global perspective.

    METHODS: An online questionnaire was developed and disseminated between May and July 2021. The survey was open to all pharmacists and pharmaceutical scientists. The survey consisted of four sections; demographic information, questions about professional organisations, about the International Pharmaceutical Federation (FIP) and its impact on the members. Data were analysed descriptively.

    RESULTS: A total of 1033 complete survey responses were received and included in the analysis. Of all respondents, 761 (73.7%) respondents were current members of a professional organisation and 272 (26.3%) were not members of any professional organisation. Overall, findings demonstrated networking, education, training and professional development opportunities as the main interests and anticipated activities, while the lack of clarity or need to join organisation, time, and financial constraints as the main barriers of pharmacy professionals holding membership. The majority of FIP members are satisfied with current FIP activities, and anticipate further networking opportunities, educational resources and grants made available to members.

    CONCLUSIONS: Understanding the perceptions and needs, as well as factors that influence engagement of pharmacists and pharmaceutical scientists is the key to enhancing membership. Professional organisations are highly encouraged to strengthen and target activities according to the identified motivators and barriers.

  13. Cilwyn-Shalitha B, Sasidharan S
    Microsc Microanal, 2023 Jun 09;29(3):1153-1167.
    PMID: 37749670 DOI: 10.1093/micmic/ozad023
    The present study investigated the effects of Polyalthia longifolia leaf extract against the growth of HeLa cell xenograft tumor in nude mice and its underlying mechanism. The nude mice xenografted with HeLa cells were treated with 5% DMSO (vehicle control), 20 mg/kg/body weight of etoposide (positive control), and 500 and 1000 mg/kg/body weight of leaf extract, respectively. Antitumor activity was evaluated with apoptosis, proliferation, and angiogenesis using microscopic-based histological and immunohistochemical microanalyses. The tumor tissue histological and immunohistochemical analyses showed that the HeLa tumor cell death was associated with apoptosis and decreased (p < 0.05) expression of Ki-67 in tumor tissues. The extract also inhibits tumor angiogenesis by downregulating (p < 0.05) the expression of VEGF and CD31 in tumor tissues after treatment for 35 days. Conclusively, the P. longifolia leaf extract effectively inhibited HeLa cell xenograft growth in nude mice. The possible mechanism was related to induction of apoptosis, inhibition of tumor HeLa cell proliferation by decreasing the Ki-67 protein expression, and prevention of tumor angiogenesis by reducing VEGF and CD31 protein expression in HeLa cells.
    MeSH terms: Animals; Body Weight; HeLa Cells; Humans; Mice, Nude; Plant Extracts/pharmacology; Plant Extracts/therapeutic use; Ki-67 Antigen; Polyalthia*; Vascular Endothelial Growth Factor A; Mice; Heterografts
  14. Barlow M, Watson B, Morse K, Jones E, Maccallum F
    J Health Organ Manag, 2023 Sep 26;ahead-of-print(ahead-of-print).
    PMID: 37749761 DOI: 10.1108/JHOM-06-2023-0171
    PURPOSE: The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.

    DESIGN/METHODOLOGY/APPROACH: The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.

    FINDINGS: The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.

    ORIGINALITY/VALUE: Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.

    MeSH terms: Emotions*; Health Facilities; Humans; Retrospective Studies; Negotiating*; Empirical Research
  15. Nyanti LE, Lee SSY, Shanmugam V, Muien MZBA, Othman AA, Chia YL, et al.
    Int J Tuberc Lung Dis, 2023 Oct 01;27(10):724-728.
    PMID: 37749834 DOI: 10.5588/ijtld.23.0079
    Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacillus Burkholderia pseudomallei. Mediastinal melioidosis has a range of clinical presentations, making it difficult to diagnose: we therefore reviewed the evidence on the clinical characteristics, radiological features and invasive diagnostic modalities or interventions. An electronic search was conducted on three databases (PubMed, SCOPUS, Google Scholar) from November to December 2022. The initial search yielded 120 results, of which 34 studies met the inclusion criteria, but only 31 full-texts were retrievable. Among these, 4 were cohort studies, 26 case reports or series and 1 a conference abstract. The four main themes covered were mediastinal melioidosis as a diagnostic dilemma, unexpected complications, invasive interventions or an accompanying thoracic feature. Radiological manifestations included matting, necrosis and abscess-like collection. Severe presentations of mediastinal melioidosis included superior vena cava obstruction, sinus tract formation and pericardial tamponade. Transbronchial needle aspiration was the most common invasive diagnostic modality. Further research is needed to understand the relationship between the thoracic features of melioidosis on patient prognosis, its relationship to melioidosis transmission and potential preventive measures.
    MeSH terms: Humans; Radiography; Vena Cava, Superior; Burkholderia pseudomallei*
  16. Al-Ashwal FY, Zawiah M, Gharaibeh L, Abu-Farha R, Bitar AN
    Drug Healthc Patient Saf, 2023;15:137-147.
    PMID: 37750052 DOI: 10.2147/DHPS.S425858
    BACKGROUND: AI platforms are equipped with advanced ‎algorithms that have the potential to offer a wide range of ‎applications in healthcare services. However, information about the accuracy of AI chatbots against ‎conventional drug-drug interaction tools is limited‎. This study aimed to assess the sensitivity, specificity, and accuracy of ChatGPT-3.5, ChatGPT-4, Bing AI, and Bard in predicting drug-drug interactions.

    METHODS: AI-based chatbots (ie, ChatGPT-3.5, ChatGPT-4, Microsoft Bing AI, and Google Bard) were compared for their abilities to detect clinically relevant DDIs for 255 drug pairs. Descriptive statistics, such as specificity, sensitivity, accuracy, negative predictive value (NPV), and positive predictive value (PPV), were calculated for each tool.

    RESULTS: When a subscription tool was used as a reference, the specificity ranged from a low of 0.372 (ChatGPT-3.5) to a high of 0.769 (Microsoft Bing AI). Also, Microsoft Bing AI had the highest performance with an accuracy score of 0.788, with ChatGPT-3.5 having the lowest accuracy rate of 0.469. There was an overall improvement in performance for all the programs when the reference tool switched to a free DDI source, but still, ChatGPT-3.5 had the lowest specificity (0.392) and accuracy (0.525), and Microsoft Bing AI demonstrated the highest specificity (0.892) and accuracy (0.890). When assessing the consistency of accuracy across two different drug classes, ChatGPT-3.5 and ChatGPT-4 showed the highest ‎variability in accuracy. In addition, ChatGPT-3.5, ChatGPT-4, and Bard exhibited the highest ‎fluctuations in specificity when analyzing two medications belonging to the same drug class.

    CONCLUSION: Bing AI had the highest accuracy and specificity, outperforming Google's Bard, ChatGPT-3.5, and ChatGPT-4. The findings highlight the significant potential these AI tools hold in transforming patient care. While the current AI platforms evaluated are not without limitations, their ability to quickly analyze potentially significant interactions with good sensitivity suggests a promising step towards improved patient safety.

  17. Tay AK, Mohsin M, Foo CYS, Rees S, Silove D
    Psychol Med, 2023 Oct;53(13):6055-6067.
    PMID: 36330832 DOI: 10.1017/S0033291722003245
    BACKGROUND: Long-term efficacy of brief psychotherapies for refugees in low-resource settings is insufficiently understood. Integrative adapt therapy (IAT) is a scalable treatment addressing refugee-specific psychosocial challenges.

    METHODS: We report 12-month post-treatment data from a single-blind, active-controlled trial (October 2017-August 2019) where 327 Myanmar refugees in Malaysia were assigned to either six sessions of IAT (n = 164) or cognitive behavioral treatment (CBT) (n = 163). Primary outcomes were posttraumatic stress disorder (PTSD), depression, anxiety, and persistent complex bereavement disorder (PCBD) symptom scores at treatment end and 12-month post-treatment. Secondary outcome was functional impairment.

    RESULTS: 282 (86.2%) participants were retained at 12-month follow-up. For both groups, large treatment effects for common mental disorders (CMD) symptoms were maintained at 12-month post-treatment compared to baseline (d = 0.75-1.13). Although participants in IAT had greater symptom reductions and larger effect sizes than CBT participants for all CMDs at treatment end, there were no significant differences between treatment arms at 12-month post-treatment for PTSD [mean difference: -0.9, 95% CI (-2.5 to 0.6), p = 0.25], depression [mean difference: 0.1, 95% CI (-0.6 to 0.7), p = 0.89), anxiety [mean difference: -0.4, 95% CI (-1.4 to 0.6), p = 0.46], and PCBD [mean difference: -0.6, 95% CI (-3.1 to 1.9), p = 0.65]. CBT participants showed greater improvement in functioning than IAT participants at 12-month post-treatment [mean difference: -2.5, 95% CI (-4.7 to -0.3], p = 0.03]. No adverse effects were recorded for either therapy.

    CONCLUSIONS: Both IAT and CBT showed sustained treatment gains for CMD symptoms amongst refugees over the 12-month period.

    MeSH terms: Myanmar; Follow-Up Studies; Humans; Malaysia; Cognitive Therapy*; Single-Blind Method
  18. Abdul Rahman NF, Davies N, Suhaimi J, Idris F, Syed Mohamad SN, Park S
    Educ Prim Care, 2023 Jul;34(4):211-219.
    PMID: 37742228 DOI: 10.1080/14739879.2023.2248070
    Clinical reasoning is a vital medical education skill, yet its nuances in undergraduate primary care settings remain debated. This systematic review explores clinical reasoning teaching and learning intricacies within primary care. We redefine clinical reasoning as dynamically assimilating and prioritising synthesised patient, significant other, or healthcare professional information for diagnoses or non-diagnoses. This focused meta-synthesis applies transformative learning theory to primary care clinical reasoning education. A comprehensive analysis of 29 selected studies encompassing various designs made insights into clinical reasoning learning dimensions visible. Primary care placements in varying duration and settings foster diverse instructional methods like bedside teaching, clinical consultations, simulated clinics, virtual case libraries, and more. This review highlights the interplay between disease-oriented and patient-centred orientations in clinical reasoning learning. Transformative learning theory provides an innovative lens, revealing stages of initiation, persistence, time and space, and competence and confidence in students' clinical reasoning evolution. Clinical teachers guide this transformation, adopting roles as fortifiers, connoisseurs, mediators, and monitors. Patient engagement spans passive to active involvement, co-constructing clinical reasoning. The review underscores theoretical underpinnings' significance in shaping clinical reasoning pedagogy, advocating broader diversity. Intentional student guidance amid primary care complexities is vital. Utilising transformative learning, interventions bridging cognitive boundaries enhance meaningful clinical reasoning learning experiences. This study contributes insights for refining pedagogy, encouraging diverse research, and fostering holistic clinical reasoning development.
    MeSH terms: Clinical Competence; Humans; Learning; Primary Health Care; Students
  19. Leong ST, Liew SY, Khaw KY, Ahmad Hassali H, Richomme P, Derbré S, et al.
    Bioorg Chem, 2023 Dec;141:106859.
    PMID: 37742494 DOI: 10.1016/j.bioorg.2023.106859
    A bio-assay guided fractionation strategy based on cholinesterase assay combined with 13C NMR-based dereplication was used to identify active metabolites from the bark of Mesua lepidota. Eight compounds were identified with the aid of the 13C NMR-based dereplication software, MixONat, i.e., sitosterol (1), stigmasterol (2), α-amyrin (3), friedelin (6), 3β-friedelinol (7), betulinic acid (9), lepidotol A (10) and lepidotol B (11). Further bio-assay guided isolation of active compounds afforded one xanthone, pyranojacareubin (12) and six coumarins; lepidotol A (10), lepidotol B (11), lepidotol E (13), lepidotin A (14), and lepidotin B (15), including a new Mammea coumarin, lepidotin C (16). All the metabolites showed strong to moderate butyrylcholinesterase (BChE) inhibition. Lepidotin B (15) exhibited the most potent inhibition towards BChE with a mix-mode inhibition profile and a Ki value of 1.03 µM. Molecular docking and molecular dynamics simulations have revealed that lepidotin B (15) forms stable interactions with key residues within five critical regions of BChE. These regions encompass residues Asp70 and Tyr332, the acyl hydrophobic pocket marked by Leu286, the catalytic triad represented by Ser198 and His438, the oxyanion hole (OH) constituted by Gly116 and Gly117, and the choline binding site featuring Trp82. To gauge the binding strength of lepidotin B (15) and to pinpoint pivotal residues at the binding interface, free energy calculations were conducted using the Molecular Mechanics Generalized Born Surface Area (MM-GBSA) approach. This analysis not only predicted a favourable binding affinity for lepidotin B (15) but also facilitated the identification of significant residues crucial for the binding interaction.
    MeSH terms: Acetylcholinesterase/metabolism; Software; Plant Bark/chemistry; Molecular Docking Simulation
  20. Meena R, Hashmi AW, Ahmad S, Iqbal F, Soni H, Meena A, et al.
    Chemosphere, 2023 Dec;343:140225.
    PMID: 37742771 DOI: 10.1016/j.chemosphere.2023.140225
    Polypropylene composites find widespread application in industries, including packaging, plastic parts, automotive, textiles, and specialized devices like living hinges known for their remarkable flexibility. This study focuses on the manufacturing of polypropylene composite specimens by incorporating varying weight percentages of fly ash particles with polypropylene using a twin-screw extruder and injection molding machine. The composites were comprehensively tested, evaluating tensile, compressive, and flexural strength, solid-state and polymer melt properties, modulus, damping, and thermal response. The findings reveal that the compressive strength of polypropylene increases up to 2 wt% of added fly ash particles and subsequently exhibits a slight decline. Tensile strength demonstrates an increase up to 1 wt% of fly ash, followed by a decrease with a 2 wt% addition, and then a subsequent increase. Flexural strength shows improvement up to 3 wt% fly ash addition before declining. The storage modulus curve is categorized into three regions: the glassy region (up to 0 °C), the glass transition region (0-50 °C), and the glass transition region of polypropylene (>50 °C), each corresponding to different molecular motions. Weight loss curves exhibit similar trends, indicating uniform pyrolysis behavior attributed to consistent chemical bonds. Plastic degradation commences around 440 °C and concludes near 550 °C. Additionally, elemental mapping of fly ash composition identified various elements such as O, Si, K, Mg, Ca, Cl, Na, P, Al, Fe, S, Cu, Ti, and Ni. These findings offer valuable insights into the mechanical and thermal properties of polypropylene composites reinforced with fly ash, rendering them suitable for a wide range of industrial applications necessitating strength and durability across temperature variations.
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