METHODS: To understand the genetic diversity, 74 DENV-2 strains were isolated from DF epidemic cases between 2017 and 2019. Combining whole genome sequencing (WGS) technology, additional phylogenetic, haplotype, amino acid (AA) substitution, and recombination analyses were performed.
RESULTS: The results revealed that strains from 2017 were closely related to those from Singapore, Malaysia, and Thailand, indicating an imported international transmission. Local strains from 2018 were clustered with those recovered from 2019 and were closely associated with Guangzhou isolates, suggesting a within-country transmission after the significant outbreak in 2017. Compared to DENV-2 virus P14337 (Thailand/0168/1979), a total of 20 AA substitutions were detected. Notably, V431I, T2881I, and K3291T mutations only occurred in indigenous cases from 2017, and A1402T, V1457I, Q2777E, R3189K, and Q3310R mutations were exclusively found in imported cases from 2018 to 2019. The recombination analysis indicated that a total of 14 recombination events were observed.
CONCLUSION: This study may improve our understanding of DENV transmission in Hangzhou and provide further insight into DENV-2 transmission and the local vaccine choice.
METHODS: MEDLINE database search was conducted using MeSH terms and Boolean operators from Jan 2000 to Jun 2022. Abstracts were screened to exclude those in languages other than English as also articles pertaining to (I) upper urinary tract surgery, (II) only laparoscopic surgery (not robot-assisted) and (III) non-urological topics. Selected articles were then reviewed and search expanded to include their references with a focus on advanced lower urinary tract reconstruction.
KEY CONTENT AND FINDINGS: The technical aspects of robotic ureteric reimplantation, continent catheterisable channel and autoaugmentation are discussed in detail. The early outcomes are comparable to open surgery. The true advantage of robotic approach becomes apparent when performing lower urinary tract reconstruction, where space in the pelvis is limited and access is challenging. Only a few centres are currently performing bladder neck surgery and bladder augmentation.
CONCLUSIONS: Robotic lower urinary tract reconstruction in children is feasible and safe. Robotic approach offers better access, especially in the limited space within the pelvis. It reduces blood loss and post-operative pain allowing early recovery and discharge. Long-term follow-up with increasing experience could further validate these early observations.
MATERIALS AND METHODS: We recruited 12 kratom-dependent subjects and 13 healthy men to participate in this study. Addiction, craving, depression, and cognitive scores were assessed. All subjects received a single bolus injection of 99mTc-TRODAT-1 with 914.1 MBq ± 65.5 of activity (mean ± SD). The brain SPECT-CT images were reconstructed using 3D ordered subset expectation maximization (3D-OSEM) along with attenuation correction (AC), scatter correction (SC), and resolution recovery (RR) with an iteration number of four and a subset of 10. The Cohen's Kappa interrater-reliability between two raters, the standardized uptake value of body weight (SUVBW), and the asymmetrical index percentage (AI%) were evaluated.
RESULTS: Kappa statistics showed a fine agreement of abnormal 99mTc-TRODAT-1 uptake in the striatum region for the kratom-dependent group with the κ value of 0.69 (p = 0.0001), and the percentage of agreement for rater 1 and rater 2 was 56% and 64%, respectively. There was a reduction in average SUV in kratom-dependent subjects compared to healthy control subjects in the left caudate and left striatum (0.938 vs. 1.251, p = 0.014, and 1.055 vs. 1.29, p = 0.036, respectively). There was a significant difference in the AI% of the caudate region between the kratom-dependent group and the normal group (33% vs. 14%, p = 0.019).
CONCLUSION: Our findings signify that kratom addiction, may cause a change in DAT level and the results can be confirmed using 99mTc-TRODAT-1 SPECT-CT.
METHODS: This observational study used an online survey and included 143 OR workers. Descriptive statistics and multilinear regression were used to examine how patient safety culture and infection prevention affects level of patient safety.
RESULTS: Most responders worked in excellent-accredited general hospitals. Most responders were male, aged between 26 to 40 years old, and had bachelor's degrees. Most were hospital-experienced nurses. Less than half had worked in units for over ten years. Organizational Learning - Continuous Improvement; Teamwork and Handoffs; and Information Exchange had the most positive responses in the OR. However, Staffing, Work Pace, and Patient Safety ranked lowest. Organizational Learning - Continuous Improvement and Hospital Management Support for Infection Prevention Efforts were found to affect OR patient safety level perceptions.
CONCLUSION: According to the findings of our study, the overall patient safety culture in the operating room remains weak which highlights the importance of continuing efforts to improve patient safety in the OR. Further study could be directed to identify organizational learning in infection prevention to enhance the patient safety in the OR.
OBJECTIVE: To pool evidence from clinical trials to study the effects of ketogenic diet on reproductive hormones (LH/FSH ratio, free testosterone, serum progesterone) and observe evidence of weight change.
METHODS: PubMed, ScienceDirect, Scopus, and Web of Science core collection were searched for clinical trials evaluating the effects of ketogenic diet in established PCOS women consistent with the Rotterdam classification. Single- or double-arm studies that included an outcome of interest were included. Two investigators worked independently to screen potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes. Data were pooled using a random-effects model. The quality of selected studies was assessed using the Cochrane Risk of Bias Tool.
RESULTS: Following ≥45 days of intervention with ketogenic diet among women with PCOS, significant improvement was observed in reproductive hormone levels, with reduced LH/FSH ratio (d -0.851; 95% CI -1.015, -0.686; P < .001), reduced serum free testosterone (d -0.223; 95% CI -0.328, -0.119; P < .001), and an increased in serum sex hormone binding globulin (SHBG) (d 9.086; 95% CI 3.379, 14.792; P = .002). Significant weight loss was unanimously observed in all included studies (d -11.56; 95% CI -14.97, -8.15; P < .001).
CONCLUSION: Short-term ketogenic diet potentially improved hormonal imbalances commonly associated with PCOS.
METHODS: This study analyzed dengue cases from January 2014 to December 2021 and COVID-19 confirmed cases from January 2020 to December 2021 which was divided into the pre (2014 to 2019) and during COVID-19 pandemic (2020 to 2021) phases. The average annual dengue case incidence for geographical and demographic subgroups were calculated and compared between the pre and during the COVID-19 pandemic phases. In addition, Spearman rank correlation was performed to determine the correlation between weekly dengue and COVID-19 cases during the COVID-19 pandemic phase.
RESULTS: Dengue trends in Malaysia showed a 4-year cyclical trend with dengue case incidence peaking in 2015 and 2019 and subsequently decreasing in the following years. Reductions of 44.0% in average dengue cases during the COVID-19 pandemic compared to the pre-pandemic phase was observed at the national level. Higher dengue cases were reported among males, individuals aged 20-34 years, and Malaysians across both phases. Weekly dengue cases were significantly correlated (ρ = -0.901) with COVID-19 cases during the COVID-19 pandemic.
CONCLUSION: There was a reduction in dengue incidence during the COVID-19 pandemic compared to the pre-pandemic phase. Significant reductions were observed across all demographic groups except for the older population (>75 years) across the two phases.
DESIGN AND METHODS: The self-administered online questionnaire contained the independent variables (demographic and hygiene factors) and the outcome variable (frequency of face mask wearing). Participants were recruited through convenience and snowball sampling techniques. Seven hundred and eight responses were collected from Malaysian adults between May and June 2020. The demographic characteristics of participants, differences in the frequency of face mask wearing across demographic factors and hierarchical multiple regression were analyzed.
RESULTS: The propensity of face mask wearing differs by gender. The hierarchical multiple regression revealed that being female, having personal protective equipment available and frequently washing hands were positively correlated with the frequency of face mask wearing. Moreover, the availability of personal protective equipment and the frequency of hand washing accounted for greater variation of the frequency of face mask wearing than gender.
CONCLUSION: Future studies should adopt established psychosocial models in conjunction with normative and cultural factors for a better understanding of underlying motivations to engage in preventive health behaviors to shape improved hygienic and societal precautionary protective behaviors in different contexts.
METHODS: Fish were injected with 100 μg/g of MPTP intraperitoneally once or twice and then assessed on days 1 to 30 post-injection.
RESULTS: Between one-time and two-time injections, there was no significant difference in most locomotor parameters, expressions of tyrosine hydroxylase-2 (th2) and dopamine transporter (dat) genes, and dopaminergic neurons (tyrosine hydroxylase positive, TH+ cells) counts. However, caspase-3 levels significantly differed between one- and two-time injections on the day 1 assessment.
DISCUSSION: Over a 30-day period, the parameters showed significant differences in swimming speed, total distance traveled, tyrosine hydroxylase-1 (th1) and dat gene expressions, caspase-3 and glutathione protein levels, and TH+ cell counts. Days 3 and 5 showed the most changes compared to the control. In conclusion, a one-time injection of MPTP with delayed assessment on days 3 to 5 is a good PD model for animal studies.
OBJECTIVE: To probe the Clinacanthus nutans leaf extract effect on oxidative stress and inflammatory markers and the Langerhans islet area in diabetic rat models.
DESIGN: An experimental laboratory in the animal model.
METHODS: Twenty-five diabetic rat models were randomly assigned into 5 clusters. Clusters 1, 2, and 3 were administered with C. nutans leaf extract in aqueous suspension with vehicle 1% Na-CMC at 75 mg/kg body weight (BW), 150 mg/kg BW, and 300 mg/kg BW, respectively. Cluster 4 was diabetic control rats administered with metformin at a 21 mg/rat dose. Cluster 5 was a control diabetic rat only administered with 1% Na-CMC suspension. Treatment was administered orally for 14 days. On the 15th day, the rats were sacrificed to obtain blood samples and pancreatic tissues. Serum interleukin (IL)-6, malondialdehyde (MDA), and tumor necrosis factor (TNF-α) were measured using the enzyme-linked immunosorbent assay (ELISA) method. Histopathological examination was performed by counting the Langerhans islet areas.
RESULTS: The average IL-6, MDA, and TNF-α levels declined in the cluster receiving C. nutans extract and were significantly different from the untreated cluster (P
OBJECTIVE: This study aimed to evaluate the effects of a patient-centered CST program on patient-centered communication scores, communication self-efficacy, and attitudes toward concordance among pharmacists in public hospitals.
METHODS: A communication skills training (CST) program was conducted among hospital pharmacists. This training intervention was developed based on patient-centered communication frameworks and techniques, namely the Four Habits Model and motivational interviewing. A pre-test/post-test quasi-experimental design was implemented for the evaluation. Pharmacists underwent pre-test/post-test audiotaped simulated consultations and completed questionnaires, including the Revised United States-Leeds Attitudes Toward Concordance scale (RUS-LATCon) and Communication Self-Efficacy scale. The Four Habits Coding Scheme (FHCS) was used to evaluate patient-centered communication scores from the audiotapes, and the Wilcoxon signed-rank test was used to analyze for differences in the pre- and post-intervention scores.
RESULTS: A total of 38 pharmacists from four tertiary hospitals participated in this study and completed the pre-test. However, due to the impact of COVID-19, only 23 pharmacists completed the post-test data collection. Improvements were noted in the FHCS scores post-training, including items related to exploring patients' concerns, acceptability, and barriers to treatment. Based on the questionnaire, there was an improvement in recognizing patients' needs and potential medication uncertainty and an increase in the overall communication self-efficacy scores after the training.
CONCLUSIONS: CST may help improve the adoption of patient-centered communication in pharmacists' consultations with patients.
MATERIALS AND METHODS: A cross-sectional study was conducted in Jordan on 143 caregivers who were randomly selected to participate in self-administered Quality of Life in Life-Threatening Illness-Family Carer Version (QOLLTI-F) questionnaire. The variables were tested using simple linear regression analyses in the SPSS.
RESULTS: Male Jordanian caregivers who provide unpaid care, reported lower quality of life than their female counterparts (p = 0.028), (p = 0.077), respectively. A high statistically significant result was found between unshared and shared care (p = 0.009). Statistically significant results were determined between single caregivers compared with those who were married or divorced (p = 0.894 and p = 0.041, respectively).
CONCLUSIONS: This study concludes that gender, care status, type of care, and marital status are direct predictors of quality of life among Jordanian caregivers.