Browse publications by year: 2023

Fulltext Uncovering the role of algal organic matter biocoating on Navicula incerta cell deposition and biofilm formation

Tong CY, Lim SL, Chua MX, Derek CJC

Bioengineered, 2023 Dec;14(1):2252213.
PMID: 37695682 DOI: 10.1080/21655979.2023.2252213

Spontaneous natural biofilm concentrates microalgal biomass on solid supports. However, the biofilm is frequently susceptible to exfoliation upon nutrient deficiency, particularly found in aged biofilm. Therefore, this study highlights a novel biofilm cultivation technique by pre-depositing the algal organic matters from marine diatom, Navicula incerta onto microporous polyvinylidene fluoride membrane to further strengthen the biofilm developed. Due to the improvement in membrane surface roughness and hydrophobicity, cells adhered most abundantly to soluble extrapolymeric substances-coated (sEPS) (76×106±16×106 cells m-2), followed by bounded EPS-coated (57.67×106±0.33×106 cells m-2), internally organic matter (IOM)-coated (39.00×106±5.19×106 cells m-2), and pristine control the least (6.22×106±0.77×106 cells m-2) at 24th h. Surprisingly, only bEPS-coated membrane demonstrated an increase in cell adhesion toward the end of the experiment at 72 h. The application of the bio-coating has successfully increased the rate of cell attachment by at least 45.3% upon inoculation and achieved as high as 89.9% faster attachment at 72 hours compared to the pristine control group. Soluble polysaccharides and proteins might be carried along by the cells adhering onto membranes hence resulting in a built up of EPS hydrophobicity (>70% in average on bio-coated membranes) over time as compared with pristine (control) that only recorded an average of approximately 50% hydrophobicity. Interestingly, cells grown on bio-coated membranes accumulated more internally bounded polysaccharides, though bio-coating had no discernible impact on the production of both externally and internally bounded protein. The collective findings of this study reveal the physiological alterations of microalgal biofilms cultured on bio-coated membranes.

MeSH terms: Cell Adhesion; Diatoms*; Biofilms; Biomass; Microalgae*
Fulltext Applying an evolutionary mismatch framework to understand disease susceptibility

Lea AJ, Clark AG, Dahl AW, Devinsky O, Garcia AR, Golden CD, et al.

PLoS Biol, 2023 Sep;21(9):e3002311.
PMID: 37695771 DOI: 10.1371/journal.pbio.3002311

Noncommunicable diseases (NCDs) are on the rise worldwide. Obesity, cardiovascular disease, and type 2 diabetes are among a long list of "lifestyle" diseases that were rare throughout human history but are now common. The evolutionary mismatch hypothesis posits that humans evolved in environments that radically differ from those we currently experience; consequently, traits that were once advantageous may now be "mismatched" and disease causing. At the genetic level, this hypothesis predicts that loci with a history of selection will exhibit "genotype by environment" (GxE) interactions, with different health effects in "ancestral" versus "modern" environments. To identify such loci, we advocate for combining genomic tools in partnership with subsistence-level groups experiencing rapid lifestyle change. In these populations, comparisons of individuals falling on opposite extremes of the "matched" to "mismatched" spectrum are uniquely possible. More broadly, the work we propose will inform our understanding of environmental and genetic risk factors for NCDs across diverse ancestries and cultures.

MeSH terms: Cardiovascular Diseases*; Disease Susceptibility; Biological Evolution; Humans; Genomics
Fulltext Emerging trends in the appliance of ultrasonic technology for valorization of agricultural residue into versatile products

Sabaruddin FA, Megashah LN, Shazleen SS, Ariffin H

Ultrason Sonochem, 2023 Oct;99:106572.
PMID: 37696213 DOI: 10.1016/j.ultsonch.2023.106572

The utilization of agricultural residues to obtain biocompounds of high-added value has significantly increased in the past decades. The conversion of agro-based residues into valuable products appears to be an economically efficient, environment-friendly, and protracted waste management practice. The implementation of ultrasonic technologies in the conversion of value-added goods from agricultural waste materials through pre-treatment and valorization processes has imparted many advantageous effects including rapid processing, effective process performance, minimization of processing steps, minimal dependency on harmful chemicals, and an increased yield and properties of bio-products. To further enliven the literature and inspire new research investigations, this review covers the comprehensive work including theoretical principles, processes, and potential benefits of ultrasonic treatment technologies to assist the production of bio-products which emphasize the extraction yield and the characteristic of the end-product extracted from agriculture residues. A detailed evaluation of these methods and key aspects impacting their performance as well as the features and shortcomings of each ultrasound-assisted approach is also discussed. This review also addressed some of the challenges associated with using ultrasonic irradiation and proposed several potential techniques to maximize productivity. Understanding the concept of ultrasonication technique allow the academician and industrial practitioners to explore the possibility of applying a greener and sustainable approach of biomass extraction to be translated into higher scale production of commercial products.
Green synthesis of chitosan/silver nanocomposite using kaempferol for triple negative breast cancer therapy and antibacterial activity

Bharathi D, Ranjithkumar R, Nandagopal JGT, Djearamane S, Lee J, Wong LS

Environ Res, 2023 Dec 01;238(Pt 1):117109.
PMID: 37696324 DOI: 10.1016/j.envres.2023.117109

The synthesis of polymer-encapsulated metal nanoparticles is a growing field of area due to their long-term uses in the development of new technologies. The present study describes the synthesis of chitosan/silver nanocomposite using kaempferol for anticancer and bactericidal activity. The formation of Kf-CS/Ag nanocomposite was confirmed by the development of a brown color and UV-absorbance around 438 nm. The IR study was utilized to determine the existence of Kf and CS in the synthesized nanocomposite. TEM analysis demonstrated that the synthesized nanocomposite have a predominantly uniform spherical shape and size ranges 7-10 nm. EDX spectrum showed the existence of Ag, C, and N elements in the nanocomposite material. Further, Kf-CS/Ag nanocomposite exhibited potential in vitro inhibitory property against triple-negative breast cancer (TNBC) cells and their IC50 values was found to be 53 μg/mL. Moreover, fluorescent assays such as DAPI and AO/EtBr confirmed the apoptosis induction ability of Kf-CS/Ag nanocomposite in MDA-MB-231 cells. The synthesized Kf-CS/Ag nanocomposite showed significant and dose-depended antibacterial property against S. aureus and P. aeruginosa. Thus, the obtained findings demonstrated that the synthesized nanocomposite can be potentially used to improve human health as biocidal nanocomposite in biomedical sectors.

MeSH terms: Anti-Bacterial Agents/pharmacology; Humans; Microbial Sensitivity Tests; Silver; Staphylococcus aureus; Kaempferols; Chitosan*; Nanocomposites*; Metal Nanoparticles*; Triple Negative Breast Neoplasms*
Interpretability of simple RNN and GRU deep learning models used to map land susceptibility to gully erosion

Gholami H, Mohammadifar A, Golzari S, Song Y, Pradhan B

Sci Total Environ, 2023 Dec 15;904:166960.
PMID: 37696396 DOI: 10.1016/j.scitotenv.2023.166960

Gully erosion possess a serious hazard to critical resources such as soil, water, and vegetation cover within watersheds. Therefore, spatial maps of gully erosion hazards can be instrumental in mitigating its negative consequences. Among the various methods used to explore and map gully erosion, advanced learning techniques, especially deep learning (DL) models, are highly capable of spatial mapping and can provide accurate predictions for generating spatial maps of gully erosion at different scales (e.g., local, regional, continental, and global). In this paper, we applied two DL models, namely a simple recurrent neural network (RNN) and a gated recurrent unit (GRU), to map land susceptibility to gully erosion in the Shamil-Minab plain, Hormozgan province, southern Iran. To address the inherent black box nature of DL models, we applied three novel interpretability methods consisting of SHaply Additive explanation (SHAP), ceteris paribus and partial dependence (CP-PD) profiles and permutation feature importance (PFI). Using the Boruta algorithm, we identified seven important features that control gully erosion: soil bulk density, clay content, elevation, land use type, vegetation cover, sand content, and silt content. These features, along with an inventory map of gully erosion (based on a 70 % training dataset and 30 % test dataset), were used to generate spatial maps of gully erosion using DL models. According to the Kolmogorov-Smirnov (KS) statistic performance assessment measure, the simple RNN model (with KS = 91.6) outperformed the GRU model (with KS = 66.6). Based on the results from the simple RNN model, 7.4 %, 14.5 %, 18.9 %, 31.2 % and 28 % of total area of the plain were classified as very-low, low, moderate, high and very-high hazard classes, respectively. According to SHAP plots, CP-PD profiles, and PFI measures, soil silt content, vegetation cover (NDVI) and land use type had the highest impact on the model's output. Overall, the DL modelling techniques and interpretation methods used in this study proved to be helpful in generating spatial maps of soil erosion hazard, especially gully erosion. Their interpretability can support watershed sustainable management.
Practice of dialysis access interventional nephrology procedures in the Asia-Pacific region: Getting lay of the land

Jasuja S, Gallieni M, Jha V, Vachharajani T, Bhalla AK, Tan J, et al.

Nephrology (Carlton), 2023 Dec;28(12):672-681.
PMID: 37697492 DOI: 10.1111/nep.14236

AIM: This cross-sectional survey aimed to determine the prevalence of Interventional Nephrology (IN) practice amongst nephrologists in the Asia-Pacific Region (APR), specifically related to dialysis access (DA).
METHODS: The Association of VA and intervenTionAl Renal physicians (AVATAR) Foundation from India conducted a multinational online survey amongst nephrologists from the Asia-Pacific to determine the practice of IN in the planning, creation, and management of dialysis access. The treatment modalities, manpower and equipment availability, monthly cost of treatment, specifics of dialysis access interventions, and challenges in the training and practice of IN by nephrologists were included in the survey.
RESULTS: Twenty-one countries from the APR participated in the survey. Nephrologists from 18 (85.7%) countries reported performing at least one of the basic dialysis access-related IN procedures, primarily the placement of non-tunnelled central catheters (n-TCC; 71.5%). Only 10 countries (47.6%) reported having an average of <4% of nephrologists performing any of the advanced IN access procedures, the most common being the placement of a peritoneal dialysis (PD) catheter (20%). Lack of formal training (57.14%), time (42.8%), incentive (38%), institutional support (38%), medico-legal protection (28.6%), and prohibitive cost (23.8%) were the main challenges to practice IN. The primary obstacles to implementing the IN training were a lack of funding and skilled personnel.
CONCLUSION: The practice of dialysis access-related IN in APR is inadequate, mostly due to a lack of training, backup support, and economic constraints, whereas training in access-related IN is constrained by a lack of a skilled workforce and finances.

MeSH terms: Asia/epidemiology; Catheterization/methods; Cross-Sectional Studies; Renal Dialysis; Humans
Identification and optimization of TDP1 inhibitors from anthraquinone and chalcone derivatives: consensus scoring virtual screening and molecular simulations

Moshawih S, Goh HP, Kifli N, Darwesh MAE, Ardianto C, Goh KW, et al.

J Biomol Struct Dyn, 2023 Sep 11.
PMID: 37697727 DOI: 10.1080/07391102.2023.2256870

Virtual screening aims to identify and rank compounds with drug/lead-like properties based on their affinity for the protein target. We developed a methodology that integrates structure- and ligand-based screening approaches to enhance hit rates against the TDP1 protein within a database of anthraquinone and chalcone derivatives, followed by evaluation of prioritized compounds through molecular simulations. This technique is particularly useful for training set imbalances. Four screening methods were used: QSAR, pharmacophore, shape similarity, and docking. Each method was individually trained to score compounds, and the scores were fused to create parallel Z-score fusion. The QSAR models exhibited satisfactory R2 values (0.84 to 0.75), whereas the pharmacophoric and shape similarity models demonstrated excellent performance (ROC:0.82-0.88). Docking enrichment analysis identified 6N0D as the optimal TDP1 crystal structure (ROC = 0.73). Remarkably, the consensus scoring method surpassed other screening methods, achieving the highest ROC value of 0.98. Docking screening prioritized compounds with binding modes resembling the co-crystallized ligands, whereas MMGBSA, consensus, and docking produced dynamic simulations that were as stable as the co-crystallized ligands. Additionally, the QSAR-selected compounds exhibited binding modes similar to those of commercially available TDP1 inhibitors. In this study, a strong correlation was found between the inhibitory concentrations and binding energy values of commercialized TDP1 inhibitors, indicating that the top-ranked compounds are expected to have potent inhibitory effects in the nano-/micromolar range. The results of this study establish that consensus scoring can be used as an adaptable mainstay virtual screening methodology, pending subsequent experimental validation for affirmation.Communicated by Ramaswamy H. Sarma.
Fulltext Controlling the critical parameters of ultrasonication to affect the dispersion state, isolation, and chiral nematic assembly of cellulose nanocrystals

Nugroho RWN, Tardy BL, Eldin SM, Ilyas RA, Mahardika M, Masruchin N

Ultrason Sonochem, 2023 Oct;99:106581.
PMID: 37690260 DOI: 10.1016/j.ultsonch.2023.106581

Cellulose nanocrystals (CNCs) are typically extracted from plants and present a range of opto-mechanical properties that warrant their use for the fabrication of sustainable materials. While their commercialization is ongoing, their sustainable extraction at large scale is still being optimized. Ultrasonication is a well-established and routinely used technology for (re-) dispersing and/or isolating plant-based CNCs without the need for additional reagents or chemical processes. Several critical ultrasonication parameters, such as time, amplitude, and energy input, play dominant roles in reducing the particle size and altering the morphology of CNCs. Interestingly, this technology can be coupled with other methods to generate moderate and high yields of CNCs. Besides, the ultrasonics treatment also has a significant impact on the dispersion state and the surface chemistry of CNCs. Accordingly, their ability to self-assemble into liquid crystals and subsequent superstructures can, for example, imbue materials with finely tuned structural colors. This article gives an overview of the primary functions arising from the ultrasonication parameters for stabilizing CNCs, producing CNCs in combination with other promising methods, and highlighting examples where the design of photonic materials using nanocrystal-based celluloses is substantially impacted.
Is teacher violence a form of betrayal trauma? Relationship with mental health problems among young adults

Fung HW, Cong CW, Tan CS, Yuan GF, Liu C, He KL, et al.

Child Abuse Negl, 2023 Nov;145:106436.
PMID: 37690435 DOI: 10.1016/j.chiabu.2023.106436

BACKGROUND: Childhood trauma is one of the most preventable risk factors for mental health problems. Considering the substantial amount of time that young people spend in school during their early years, it is important to understand the potential impacts of teachers' behaviors on students' mental health.
OBJECTIVES: This study examined the relationship between exposure to teacher violence and mental health problems.
PARTICIPANTS AND SETTING: An international sample of young adults aged 18 to 24 (N = 283).
METHODS: Participants completed self-report measures of childhood trauma, exposure to teacher violence, depressive symptoms, post-traumatic stress, and alcohol misuse.
RESULTS: Exposure to teacher violence could be reliably and validly measured using the Teacher Violence Scale (TVS). Current mental health problems - including depressive symptoms, post-traumatic stress, and alcohol misuse - were associated with exposure to teacher violence during high school years, but not with childhood non-betrayal trauma.
CONCLUSIONS: Our findings expand the application of the betrayal trauma theory to school settings and point to the importance of preventing and managing teacher violence. It is important to provide more support and training to teachers and enhance monitoring measures in schools. More research on the prevalence and correlates of exposure to teacher violence is needed. We also provided first evidence supporting the reliability and validity of the English version of the TVS to facilitate future research.

MeSH terms: Adolescent; Ethanol; Alcoholism*; Humans; Mental Health; Violence; Reproducibility of Results; Young Adult; Educational Personnel*
Conversion of archeological iron rust employing coconut husk lignin

Nasrun Z, Osman LS, Latif NHA, Elias NHH, Saidin M, Shahidan S, et al.

Int J Biol Macromol, 2023 Dec 31;253(Pt 2):126786.
PMID: 37690637 DOI: 10.1016/j.ijbiomac.2023.126786

Rust powder collected from an archeological iron was evaluated by complementary analyses such as FTIR, XRD, XRF, and SEM/EDX. The analyses revealed that lepidocrocite (L) was the major component in the archeological iron. Coconut husk (CH) can be classified as a type of lignocellulosic biomass of renewable resources that are widely available, especially in coastal areas. In this research, the isolated lignin extracted from CH is being studied as a potential alternative for environmentally friendly applications. The isolated lignin from soda and organosolv pulping went through several analyses such as FTIR, NMR (13C and 2D-HSQC), and TGA analyses. The analyses showed that lignin isolated via soda pulping has superior antioxidant capabilities due to its greater phenolic-OH content compared to lignin isolated from organosolv pulping. The effects of lignin concentrations, pH, and reaction time were utilized in rust conversion studies of an archeological iron. 5 wt% of soda lignin (SL) was revealed as the ideal condition in this rust conversion study with a value of 84.21 %. The treated rust powder with 5 wt% of SL was then further gone through several complementary analyses, which revealed that the treated rust had nearly transformed into an amorphous state.
Current issues and potential solutions for the electrospinning of major polysaccharides and proteins: A review

Syed MH, Khan MMR, Zahari MAKM, Beg MDH, Abdullah N

Int J Biol Macromol, 2023 Dec 31;253(Pt 2):126735.
PMID: 37690643 DOI: 10.1016/j.ijbiomac.2023.126735

Biopolymers, especially polysaccharides and proteins, are the promising green replacement for petroleum based polymers. Due to their innate properties, they are effectively used in biomedical applications, especially tissue engineering, wound healing, and drug delivery. The fibrous morphology of biopolymers is essentially required for the effectiveness in these biomedical applications. Electrospinning (ES) is the most advanced and robust method to fabricate nanofibers (NFs) and provides a complete solution to the conventional methods issues. However, the major issues regarding fabricating polysaccharides and protein nanofibers using ES include poor electrospinnability, lack of desired fundamental properties for a specific application by a single biopolymer, and insolubility among common solvents. The current review provides the main strategies for effective electrospinning of the major biopolymers. The key strategies include blending major biopolymers with suitable biopolymers and optimizing the solvent system. A systematic literature review was done to provide the optimized solvent system of the major biopolymers along with their best possible biopolymeric blend for ES. The review also highlights the fundamental issues with the commercialization of ES based biomedical products and provides future directions to improve the fabrication of biopolymeric nanofibers.
Do natural resources affect environmental quality in MINT Economies? The role of tourism and financial development

Faisal F, Rahman SU, Ali A, Sulimany HGH, Bazhair AH, Pervaiz R

Environ Sci Pollut Res Int, 2023 Oct;30(47):103958-103971.
PMID: 37691062 DOI: 10.1007/s11356-023-29520-7

With the growing nature of the ecological footprint, research studies focus on exploring new determinants of environmental degradation. Moreover, the role of natural resources and energy consumption in environmental quality has gained much attention in the literature. However, tourism raises the demand for energy consumption and extraction of natural resources. This research study investigates the influence of natural resources, tourism, and renewable energy in MINT countries, using novel Cross-Sectional Auto Regressive Distributive Lag (CS-ARDL) methodological techniques and employing yearly data from 1995 to 2018. The study also applied recently developed Kónya (Econ Model 23:978-992, 2006) causality to identify the causal relationship between the variables of the heterogenous panel. The result shows that tourism, natural resources, and economic growth are positively associated with the ecological footprint in the long-run. However, renewable energy consumption negatively impacts ecological footprint in both in short-run and the long-run. Further, the study explored a bidirectional causality between economic growth and ecological footprint in MINT countries. Finally, based on the empirical results, the study recommends that the authorities in MINT countries revisit their tourism, natural resources, and economic activities policies to enhance the environmental quality and reduce the ecological footprint.

MeSH terms: Natural Resources; Carbon Dioxide*; Cross-Sectional Studies; Economic Development; Renewable Energy
Creatinine clearance in selection of living kidney donor among the Malaysian population: is it safe?

Thye CK, Lee YW, Jalalonmuhali M, Lim SK, Ng KP

BMC Nephrol, 2023 Sep 11;24(1):267.
PMID: 37691129 DOI: 10.1186/s12882-023-03057-w

BACKGROUND: Assessment of donor renal function is made by the measurement of Glomerular Filtration Rate (GFR). Exogenous markers are preferred over creatinine clearance and are widely used for measuring GFR. However, they are difficult to obtain, costly and laborious. This is a study to look into the safety and accuracy of creatinine clearance for renal assessment among the living kidney donors in the Malaysian population.
METHODS: This is a retrospective, single-centre study comprising 105 living kidney donor candidates from the year 2007 to 2020. By comparing against 51-Chromium ethylenediamine-tetraacetic acid (51Cr-EDTA), we analysed creatinine clearance for correlation, bias, precision and accuracy.
RESULTS: The study group had a mean age of 45.68 ± 10.97 years with a mean serum creatinine of 64.43 ± 17.68 µmol/L and a urine volume of 2.06 ± 0.83 L. Mean measured GFR from 51Cr-EDTA was 124.37 ± 26.83 ml/min/1.73m2 whereas mean creatinine clearance was 132.35 ± 38.18 ml/min/1.73m2. Creatinine clearance overestimated 51Cr-EDTA significantly with a correlation coefficient of 0.48 (p

MeSH terms: Adult; Creatinine; Edetic Acid; Humans; Middle Aged; Retrospective Studies; Kidney Transplantation*; Living Donors
Intranasal nanoparticulate delivery systems for neurodegenerative disorders: a review

Babu SR, Shekara HH, Sahoo AK, Harsha Vardhan PV, Thiruppathi N, Venkatesh MP

Ther Deliv, 2023 Sep;14(9):571-594.
PMID: 37691577 DOI: 10.4155/tde-2023-0019

Neurodegenerative diseases are a significant cause of mortality worldwide, and the blood-brain barrier (BBB) poses a significant challenge for drug delivery. An intranasal route is a prominent approach among the various methods to bypass the BBB. There are different pathways involved in intranasal drug delivery. The drawbacks of this method include mucociliary clearance, enzymatic degradation and poor drug permeation. Novel nanoformulations and intranasal drug-delivery devices offer promising solutions to overcome these challenges. Nanoformulations include polymeric nanoparticles, lipid-based nanoparticles, microspheres, liposomes and noisomes. Additionally, intranasal devices could be utilized to enhance drug-delivery efficacy. Therefore, intranasal drug-delivery systems show potential for treating neurodegenerative diseases through trigeminal or olfactory pathways, which can significantly improve patient outcomes.

MeSH terms: Administration, Intranasal; Blood-Brain Barrier/metabolism; Brain/metabolism; Humans; Drug Delivery Systems; Nanoparticles*
Fulltext Can Amphotericin B-mediated effects be limited using intranasal versus intravenous route?

Siddiqui R, Yee Ong TY, Maciver S, Khan NA

Ther Deliv, 2023 Aug;14(8):485-490.
PMID: 37691579 DOI: 10.4155/tde-2023-0032

Aim: CNS infections due to parasites often prove fatal. In part, this is due to inefficacy of drugs to cross the blood-brain barrier. Methods: Here, we tested intranasal and intravenous route and compared adverse effects of Amphotericin B administration, through blood biochemistry, liver, kidney and brain histopathological evidence of toxicities in vivo post-administration. Results: It was observed that intranasal route limits the adverse side effects of Amphotericin B, in contrast to intravenous route. Conclusion: As parasites such as Naegleria fowleri exhibit unequivocal affinity toward the olfactory bulb and frontal lobe in the central nervous system, intranasal administration would directly reach amoebae bypassing the blood-brain barrier selectivity and achieve the minimum inhibitory concentration at the target site.

MeSH terms: Administration, Intranasal; Amphotericin B*; Blood-Brain Barrier*; Brain; Liver
Fulltext Recommended first-line management of asymptomatic brain metastases from EGFR mutant and ALK positive non-small cell lung cancer varies significantly according to specialty: an international survey of clinical practice

Fong CH, Meti N, Kruser T, Weiss J, Liu ZA, Takami H, et al.

J Thorac Dis, 2023 Aug 31;15(8):4367-4378.
PMID: 37691657 DOI: 10.21037/jtd-22-697

BACKGROUND: The role for radiotherapy or surgery in the upfront management of brain metastases (BrM) in epidermal growth factor receptor mutant (EGFRm) or anaplastic lymphoma kinase translocation positive (ALK+) non-small cell lung cancer (NSCLC) is uncertain because of a lack of prospective evidence supporting tyrosine kinase inhibitor (TKI) monotherapy. Further understanding of practice heterogeneity is necessary to guide collaborative efforts in establishing guideline recommendations.
METHODS: We conducted an international survey among medical (MO), clinical (CO), and radiation oncologists (RO), as well as neurosurgeons (NS), of treatment recommendations for asymptomatic BrM (in non-eloquent regions) EGFRm or ALK+ NSCLC patients according to specific clinical scenarios. We grouped and compared treatment recommendations according to specialty. Responses were summarized using counts and percentages and analyzed using the Fisher exact test.
RESULTS: A total of 449 surveys were included in the final analysis: 48 CO, 85 MO, 60 NS, and 256 RO. MO and CO were significantly more likely than RO and NS to recommend first-line TKI monotherapy, regardless of the number and/or size of asymptomatic BrM (in non-eloquent regions). Radiotherapy in addition to TKI as first-line management was preferred by all specialties for patients with ≥4 BrM. NS recommended surgical resection more often than other specialties for BrM measuring >2 cm.
CONCLUSIONS: Recommendations for the management of BrM from EGFRm or ALK+ NSCLC vary significantly according to oncology sub-specialties. Development of multidisciplinary guidelines and further research on establishing optimal treatment strategies is warranted.
The impact of COVID-19 on students' anxiety and its clarification: a systematic review

Wu J, Kuan G, Lou H, Hu X, Masri MN, Sabo A, et al.

Front Psychol, 2023;14:1134703.
PMID: 37691784 DOI: 10.3389/fpsyg.2023.1134703

INTRODUCTION: Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.
METHODS: A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed.
RESULTS: A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.
CONCLUSION: Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.
Fulltext Cantonese media promotes Chinese cultural identification: structural equation modeling based on Malaysian Chinese

Liu N, Chen T, Peng Y, Xie Y

Front Psychol, 2023;14:1217340.
PMID: 37691799 DOI: 10.3389/fpsyg.2023.1217340

INTRODUCTION: Language media from one's hometown is an important means of maintaining cultural identification, especially for minorities. Cantonese media plays an active role in shaping the Chinese cultural identification of ethnic Chinese all over the world. To date, few researchers have undertaken quantitative empirical analyses of the mechanism through which Cantonese media influences cultural identification.
METHODS: Using data from 642 Malaysian Chinese, this study established a structural equation model with the partial least squares method.
RESULTS: We found that the emotional affinity of ethnic Chinese to Cantonese media can influence identification with Chinese culture through the perceived value of Cantonese media and cognition of Chinese culture. The perceived value of Cantonese media (IE = 0.208) and cognition of Chinese culture (IE = 0.068) play partial mediation roles. Meanwhile, emotional affinity to Cantonese media influences cognition of Chinese culture (IE = 0.069) through the chain mediation of perceived value of Cantonese media and cognition of Chinese culture. Age has a partial moderating effect in the structural equation model. Compared with minors, adults' emotional affinity to Cantonese media can eventually influence identification with Chinese culture (TEdiff = 0.126) more strongly through several mediation paths.
DISCUSSION: The study suggests a need to cultivate the emotional affinity of ethnic Chinese to Cantonese media, improve the multidimensional values of Cantonese media, and endow Cantonese media with functions of cultural dialog and knowledge transmission. The international transmission of Cantonese media could play a vital role in building a cultural community for ethnic Chinese globally.
Antibacterial activity of hexane and methanol fractions of some selected plants against Klebsiella pneumoniae

Andriani Y, Hanifah W, Kholieqoh AH, Abdul Majid FA, Hermansyah H, Amir H, et al.

J Adv Pharm Technol Res, 2023;14(3):220-225.
PMID: 37692002 DOI: 10.4103/JAPTR.JAPTR_183_23

Besides adenovirus, pneumonia can also be caused by bacteria. One of the most common bacteria causing the pneumonia is Klebsiella pneumoniae. Currently, treatment by antibiotics has been widely used. Nevertheless, the increasing failure of existing antibiotics because of antibiotic resistance resulted by bacterial pathogens has become a serious problem to human health. Hence, there is a need for a new antibacterial potential agent against K. pneumoniae as an alternative treatment to the pneumonia to prevent the risk of a severe pneumonia for both healthy people and those already infected with the pneumonia. This study, therefore, investigated the antibacterial activity of some selected plants (Pandanus tectorius, Nypa fruticans, Sonneratia alba, Phaleria macrocarpa, Hibiscus tiliaceus, and Pongamia pinnata) against K. pneumoniae. In this study, samples were extracted successively by cold maceration using hexane and methanol. Antibacterial activity was determined by well and disc diffusion methods. Each fraction was prepared by two-fold dilutions from 20 mg/mL to 0.156 mg/mL. All data were analyzed in triplicate replication and presented as mean values ± standard deviation. Results showed that all methanol fractions of selected plants had antibacterial activity against K. pneumoniae, and well-diffusion method showed better antibacterial results compared to the agar well-diffusion method. The strongest activity was obtained by methanol fraction of S. alba leaf, followed by P. pinnata leaf, Nypa fruticans bark, H. tiliaceus leaf, P. macrocarpa leaf, and P. tectorius leaf with the minimum inhibitory concentrations (MICs) value between 0.625 and 5.0 mg/mL. Phytochemical screening revealed that all methanol fractions were rich in flavonoid content, which could have contributed to their antibacterial activity.
Changes in antioxidant status and DNA repair capacity are corroborated with molecular alterations in malignant thyroid tissue of patients with papillary thyroid cancer

Eng ZH, Abdul Aziz A, Ng KL, Mat Junit S

Front Mol Biosci, 2023;10:1237548.
PMID: 37692064 DOI: 10.3389/fmolb.2023.1237548

Introduction: Papillary thyroid cancer (PTC) accounts for approximately 80% of all thyroid cancer cases. The mechanism of PTC tumourigenesis is not fully understood, but oxidative imbalance is thought to play a role. To gain further insight, this study evaluated antioxidant status, DNA repair capacity and genetic alterations in individuals diagnosed with benign thyroid lesion in one lobe (BTG) and PTC lesion in another. Methods: Individuals with coexisting BTG and PTC lesions in their thyroid lobes were included in this study. Reactive oxygen species (ROS) level, ABTS radical scavenging activity, ferric reducing antioxidant capacity, glutathione peroxidase and superoxide dismutase activities were measured in the thyroid tissue lysate. The expression of selected genes and proteins associated with oxidative stress defence and DNA repair were analysed through quantitative real-time PCR and Western blotting. Molecular alterations in genomic DNA were analysed through whole-exome sequencing and the potentially pathogenic driver genes filtered through Cancer-Related Analysis of Variants Toolkit (CRAVAT) analysis were subjected to pathway enrichment analysis using Metascape. Results: Significantly higher ROS level was detected in the PTC compared to the BTG lesions. The PTC lesions had significantly higher expression of GPX1, SOD2 and OGG1 but significantly lower expression of CAT and PRDX1 genes than the BTG lesions. Pathway enrichment analysis identified "regulation of MAPK cascade," "positive regulation of ERK1 and ERK2 cascade" and "negative regulation of reactive oxygen species metabolic process" to be significantly enriched in the PTC lesions only. Four pathogenic genetic variants were identified in the PTC lesions; BRAF V600E, MAP2K7-rs2145142862, BCR-rs372013175 and CD24 NM_001291737.1:p.Gln23fs while MAP3K9 and G6PD were among 11 genes that were mutated in both BTG and PTC lesions. Conclusion: Our findings provided further insight into the connection between oxidative stress, DNA damage, and genetic changes associated with BTG-to-PTC transformation. The increased oxidative DNA damage due to the heightened ROS levels could have heralded the BTG-to-PTC transformation, potentially through mutations in the genes involved in the MAPK signalling pathway and stress-activated MAPK/JNK cascade. Further in-vitro functional analyses and studies involving a larger sample size would need to be carried out to validate the findings from this pilot study.

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