Browse publications by year: 2023

  1. Ramanjot, Mittal U, Wadhawan A, Singla J, Jhanjhi NZ, Ghoniem RM, et al.
    Sensors (Basel), 2023 May 15;23(10).
    PMID: 37430683 DOI: 10.3390/s23104769
    A significant majority of the population in India makes their living through agriculture. Different illnesses that develop due to changing weather patterns and are caused by pathogenic organisms impact the yields of diverse plant species. The present article analyzed some of the existing techniques in terms of data sources, pre-processing techniques, feature extraction techniques, data augmentation techniques, models utilized for detecting and classifying diseases that affect the plant, how the quality of images was enhanced, how overfitting of the model was reduced, and accuracy. The research papers for this study were selected using various keywords from peer-reviewed publications from various databases published between 2010 and 2022. A total of 182 papers were identified and reviewed for their direct relevance to plant disease detection and classification, of which 75 papers were selected for this review after exclusion based on the title, abstract, conclusion, and full text. Researchers will find this work to be a useful resource in recognizing the potential of various existing techniques through data-driven approaches while identifying plant diseases by enhancing system performance and accuracy.
    MeSH terms: Agriculture*; Humans; India; Plant Diseases*; Research Personnel; Databases, Factual
  2. Sathish K, Cv R, Ab Wahab MN, Anbazhagan R, Pau G, Akbar MF
    Sensors (Basel), 2023 May 17;23(10).
    PMID: 37430763 DOI: 10.3390/s23104844
    Underwater Wireless Sensor Networks (UWSNs) have recently established themselves as an extremely interesting area of research thanks to the mysterious qualities of the ocean. The UWSN consists of sensor nodes and vehicles working to collect data and complete tasks. The battery capacity of sensor nodes is quite limited, which means that the UWSN network needs to be as efficient as it can possibly be. It is difficult to connect with or update a communication that is taking place underwater due to the high latency in propagation, the dynamic nature of the network, and the likelihood of introducing errors. This makes it difficult to communicate with or update a communication. Cluster-based underwater wireless sensor networks (CB-UWSNs) are proposed in this article. These networks would be deployed via Superframe and Telnet applications. In addition, routing protocols, such as Ad hoc On-demand Distance Vector (AODV), Fisheye State Routing (FSR), Location-Aided Routing 1 (LAR1), Optimized Link State Routing Protocol (OLSR), and Source Tree Adaptive Routing-Least Overhead Routing Approach (STAR-LORA), were evaluated based on the criteria of their energy consumption in a range of various modes of operation with QualNet Simulator using Telnet and Superframe applications. STAR-LORA surpasses the AODV, LAR1, OLSR, and FSR routing protocols in the evaluation report's simulations, with a Receive Energy of 0.1 mWh in a Telnet deployment and 0.021 mWh in a Superframe deployment. The Telnet and Superframe deployments consume 0.05 mWh transmit power, but the Superframe deployment only needs 0.009 mWh. As a result, the simulation results show that the STAR-LORA routing protocol outperforms the alternatives.
  3. Sem SH, Chen Kang W
    Cureus, 2023 Jun;15(6):e40175.
    PMID: 37431353 DOI: 10.7759/cureus.40175
    Cat scratch disease (CSD) is an uncommon condition. When a patient is infected, the disease is often self-limiting. Cat scratch disease involving the musculoskeletal system had been described, but the manifestation of the disease in hand remained unexplored. We report a case of chronic flexor tenosynovitis of the left index finger caused by cat scratch disease. In this case, the antibiotic treatment did not improve the clinical outcome. However, surgical debridement of the diseased finger resulted in a tremendous improvement in terms of pain and range of motion.
  4. Mohd Hatta FH, Samsudin EZ, Aimran N, Ismail Z
    Risk Manag Healthc Policy, 2023;16:1229-1240.
    PMID: 37431510 DOI: 10.2147/RMHP.S411335
    INTRODUCTION: Workplace violence (WPV) incidences are prevalent in healthcare, and existing WPV interventions have only moderate evidence for effectiveness. This study aimed to develop and validate an instrument to assess worksite-specific WPV risk factors in healthcare settings based on a tripartite perspective of key stakeholders to facilitate improved interventions.

    METHODS: Three questionnaires were developed to get the responses from healthcare administrators, workers, and clients, representing the three components of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF). The domains of the questionnaires were developed based on The Chappell and Di Martino's Interactive Model of Workplace Violence, and the items were generated from 28 studies identified from a systematic review of the literature. Six experts, 36 raters, and 90 respondents were recruited to assess the content validity, face validity, and usability and reliability of the QAWRF respectively. Item and Scale Level Content Validity Index, Item and Scale Level Face Validity Index, and Cronbach's alpha values were determined for QAWRF-administrator, QAWRF-worker, and QAWRF-client.

    RESULTS: The psychometric indices for QAWRF are satisfactory.

    CONCLUSION: QAWRF holds good content validity, face validity, and reliability, and findings from QAWRF can contribute towards worksite-specific interventions that are expected to be resource efficient and more effective than general WPV interventions.

  5. Taer E, Yanti N, Padang E, Apriwandi A, Zulkarnain Z, Haryanti NH, et al.
    J Sci Food Agric, 2023 Dec;103(15):7411-7423.
    PMID: 37431642 DOI: 10.1002/jsfa.12846
    BACKGROUND: Porous carbon electrode (PCE) is identified as a highly suitable electrode material for commercial application due to its production process, which is characterized by simplicity, cost-effectiveness and environmental friendliness. PCE was synthesized using torch ginger (Etlingera elatior (Jack) R.M. Smith) leaves as the base material. The leaves were treated with different concentrations of ZnCl2 , resulting in a supercapacitor cell electrode with unique honeycomb-like three-dimensional (3D) morphological pore structure. This PCE comprises nanofibers from lignin content and volatile compounds from aromatic biomass waste.

    RESULTS: From the characterization of physical properties, PCE-0.3 had an impressive amorphous porosity, wettability and 3D honeycomb-like structural morphology with a pore framework consisting of micropores and mesopores. According to the structural advantages of 3D hierarchical pores such as interconnected honeycombs, PCE-0.3 as supercapacitor electrode had a high specific capacitance of up to 285.89 F g-1 at 1 A. Furthermore, the supercapacitor exhibited high energy and power density of 21.54 Wh kg-1 and 161.13 W kg-1 , respectively, with a low internal resistance of 0.059 Ω.

    CONCLUSION: The results indicated that 3D porous carbon materials such as interconnected honeycombs derived from the aromatic biomass of torch ginger leaves have significant potential for the development of sustainable energy storage devices. © 2023 Society of Chemical Industry.

    MeSH terms: Carbon/chemistry; Electrodes; Lignin; Biomass; Ginger*
  6. Malik JA, Ansari JA, Ahmed S, Khan A, Ahemad N, Anwar S
    Ther Deliv, 2023 May;14(5):357-381.
    PMID: 37431741 DOI: 10.4155/tde-2023-0020
    Breast cancer (BC) is among the most frequent malignancies women face around the globe. Nanotherapeutics are constantly evolving to overcome the limitations of conventional diagnostic and therapeutic approaches. Nanotechnology-based nanocarriers have a higher entrapment efficiency, low cytotoxicity, greater stability and improved half-life than conventional therapy. Nano-drug delivery systems have improved pharmacokinetics and pharmacodynamics parameters because of nanomeric size. Currently, various nano-formulations are in preclinical and clinical settings for breast cancer, like polymeric nanoparticles, micelles, nanobodies, magnetic nanoparticles, liposomes, niosomes, gold-nanoparticles, dendrimers and carbon-nanotubes. This review highlights the recent advancement in developing nano-drug delivery systems for BC treatment. This review will open the gateway to researchers to understand the current approaches to developing nano-formulation and improving problems associated with conventional therapy.
    MeSH terms: Female; Humans; Liposomes; Drug Delivery Systems; Nanotechnology; Nanotubes, Carbon*; Nanoparticles*
  7. Chang CY, Lee HL
    J Ayub Med Coll Abbottabad, 2023;35(2):331-333.
    PMID: 37422833 DOI: 10.55519/JAMC-02-11131
    Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis. Melioidosis is a potentially fatal disease that is endemic in Southeast Asia and Northern Australia and is being increasingly recognized in other regions worldwide. Melioidosis can affect any organ system and present with a wide range of clinical manifestations including pneumonia, bone, skin/soft tissue, or central nervous system infections. In this report, we describe a diabetic farmer who succumbed to persistent B. pseudomallei bacteraemia with multiorgan involvement despite treatment with meropenem and ceftazidime.
    MeSH terms: Abscess/complications; Abscess/microbiology; Anti-Bacterial Agents/therapeutic use; Humans; Burkholderia pseudomallei*
  8. Koh EJ, Tan KN, Chan ZW, Candice Wong HY, Chin ML, Lee TC
    J Ayub Med Coll Abbottabad, 2023;35(2):334-336.
    PMID: 37422834 DOI: 10.55519/JAMC-02-11470
    Burkholderia pseudomallei affecting the central nervous system has been extensively reported in the literature. However, combined central nervous system and peripheral nervous system involvement in melioidosis has never been reported. We report a 66-year-old man with diabetes mellitus who was diagnosed to have central nervous system melioidosis and developed acute flaccid quadriplegia. Nerve conduction studies and anti-ganglioside antibodies were consistent with Guillain-Barre syndrome. This case report highlights the importance to recognise the possibility of Guillain Barre syndrome complicating central nervous system melioidosis and stresses the urgency of early consideration of this complication, as early immunomodulatory therapy may hasten neurological recovery.
    MeSH terms: Aged; Central Nervous System; Humans; Male
  9. Chang CY
    J Ayub Med Coll Abbottabad, 2023;35(2):348-350.
    PMID: 37422837 DOI: 10.55519/JAMC-02-11390
    BACKGROUND: Splenic abscess is an uncommon condition, with autopsy studies estimating an incidence rate of 0.14-0.70%. Causative organisms can be extremely diverse. Burkholderia pseudomallei is the most common cause of splenic abscess in melioidosis-endemic areas.

    METHODS: We reviewed 39 cases of splenic abscesses in a district hospital in Kapit, Sarawak, from January 2017 to December 2018. The demographics, clinical characteristics, underlying diseases, causative organisms, therapeutic methods, and mortality rates were investigated.

    RESULTS: There were 21 males and 18 females (mean age, 33.7±2.7 years). Almost all patients (97.4%) had a history of pyrexia. Diabetes mellitus was present in 8 patients (20.5%). Splenic abscesses were diagnosed using ultrasonography and were multiple in all 39 cases. Positive blood cultures were obtained in 20 patients (51.3%), and all yielded B. pseudomallei. Melioidosis serology was positive in 9 of 19 patients (47.4%) with negative blood cultures. All patients were treated for melioidosis with antibiotics without the need for surgical intervention. All splenic abscesses resolved after anti-melioidosis treatment was completed. One patient died (2.6%) as a result of B. pseudomallei septicaemia with multiorgan failure.

    CONCLUSIONS: Ultrasonography is a valuable tool for diagnosing splenic abscesses in resource-limited settings. B. pseudomallei was the most common etiological agent of splenic abscesses in our study.

    MeSH terms: Abscess/complications; Abscess/therapy; Adult; Anti-Bacterial Agents/therapeutic use; Borneo; Female; Humans; Malaysia; Male; Burkholderia pseudomallei*
  10. Sharaf Aldeen EM, Jalil AA, Mim RS, Hatta AH, Hazril NIH, Chowdhury A, et al.
    Environ Res, 2023 Oct 01;234:116576.
    PMID: 37423362 DOI: 10.1016/j.envres.2023.116576
    Photocatalysis utilizing semiconductors offer a cost-effective and promising solution for the removal of pollutants. MXene and perovskites, which possess desirable properties such as a suitable bandgap, stability, and affordability, have emerged as a highly promising material for photocatalytic activity. However, the efficiency of MXene and perovskites is limited by their fast recombination rates and inadequate light harvesting abilities. Nonetheless, several additional modifications have been shown to enhance their performance, thereby warranting further exploration. This study delves into the fundamental principles of reactive species for MXene-perovskites. Various methods of modification of MXene-perovskite-based photocatalysts, including Schottky junction, Z-scheme and S-scheme are analyzed with regard to their operation, differences, identification techniques and reusability. The assemblance of heterojunctions is demonstrated to enhance photocatalytic activity while also suppressing charge carrier recombination. Furthermore, the separation of photocatalysts through magnetic-based methods is also investigated. Consequently, MXene-perovskite-based photocatalysts are seen as an exciting emerging technology that necessitates further research and development.
    MeSH terms: Catalysis; Environmental Pollutants*; Calcium Compounds; Environmental Restoration and Remediation*
  11. Krishnan H, Gopinath SCB
    Int J Biol Macromol, 2023 Aug 30;247:125740.
    PMID: 37423441 DOI: 10.1016/j.ijbiomac.2023.125740
    Anticoagulant therapies are crucial in the management of surgical complications as well as the prophylaxis of thrombosis. Many studies are being conducted on the Habu snake-venom anticoagulant, FIX-binding protein (FIX-Bp), for its greater potency and strong affinity to FIX clotting factor. On the other hand, the capacity to promptly reverse such acute anticoagulation is equally important. Combining a reversible anticoagulant with FIX-Bp may be advantageous in maintaining the balance between adequate anticoagulation and repealing when necessary. In this study, authors integrated FIX-Bp and RNA aptamer-based anticoagulants into a single target, FIX clotting factor, in order to achieve a robust anticoagulant effect. An in-silico and electrochemical approach were used to investigate the combination of FIX-Bp and RNA aptamers as a bivalent anticoagulant and to verify the competing or predominant binding sites of each anticoagulant. The in-silico analysis discovered that both the venom- and aptamer-anticoagulant had a strong affinity for the FIX protein at the Gla-domain and EGF-1 domain by holding 9 conventional hydrogen bonds with the binding energy of -34.859 kcal/mol. The electrochemical technique verified that both anticoagulants had different binding sites. The impedance load upon RNA aptamer binding to FIX protein was 14 %, whereas the addition of FIX-Bp caused a significant impedance rise of 37 %. This indicates that the addition of aptamers prior to FIX-Bp is a promising strategy for the conception of a hybrid anticoagulant.
    MeSH terms: Blood Coagulation Factors; Carrier Proteins/chemistry; Snake Venoms
  12. Patel JH, Amaral AFS, Minelli C, Elfadaly FG, Mortimer K, El Sony A, et al.
    Thorax, 2023 Sep;78(9):942-945.
    PMID: 37423762 DOI: 10.1136/thorax-2022-218668
    Poverty is strongly associated with all-cause and chronic obstructive pulmonary disease (COPD) mortality. Less is known about the contribution of poverty to spirometrically defined chronic airflow obstruction (CAO)-a key characteristic of COPD. Using cross-sectional data from an asset-based questionnaire to define poverty in 21 sites of the Burden of Obstructive Lung Disease study, we estimated the risk of CAO attributable to poverty. Up to 6% of the population over 40 years had CAO attributable to poverty. Understanding the relationship between poverty and CAO might suggest ways to improve lung health, especially in low-income and middle-income countries.
    MeSH terms: Cross-Sectional Studies; Forced Expiratory Volume; Humans; Lung; Poverty; Risk Factors; Spirometry; Vital Capacity; Pulmonary Disease, Chronic Obstructive*
  13. Idris SH, Mat Jalaluddin NS, Chang LW, 曾 立纬
    J Zhejiang Univ Sci B, 2023 Jul 06.
    PMID: 37423764 DOI: 10.1631/jzus.B2200601
    Biotechnology policies and regulations must be revised and updated to reflect the most recent advances in plant-breeding technology. New Plant Breeding Techniques (NPBT) such as gene editing have been applied to address the myriad of challenges in plant breeding, while the use of NPBT as emerging biotechnological tools raises legal and ethical concerns. This study aims to highlight how gene editing is operationalized in the existing literature and examine the critical issues of ethical and legal issues of gene editing for plant breeding. We carried out a systematic literature review (SLR) to provide the current states of ethical and legal discourses surrounding this topic. We also identified critical research priority areas and policy gaps that must be addressed when designing the future governance of gene editing in plant breeding.
  14. Navaretnam R, Hassan HN, Isa NM, Aris AZ, Looi LJ
    Environ Sci Pollut Res Int, 2023 Aug;30(37):87695-87720.
    PMID: 37423935 DOI: 10.1007/s11356-023-28459-z
    Rice is a predominant staple food in many countries. It is a great source of energy but can also accumulate toxic and trace metal(loid)s from the environment and pose serious health hazards to consumers if overdosed. This study aims to determine the concentration of toxic metal(loid)s [arsenic (As), cadmium (Cd), nickel (Ni)] and essential metal(loid)s [iron (Fe), selenium (Se), copper (Cu), chromium (Cr), cobalt (Co)] in various types of commercially available rice (basmati, glutinous, brown, local whites, and fragrant rice) in Malaysia, and to assess the potential human health risk. Rice samples were digested following the USEPA 3050B acid digestion method and the concentrations of metal(loid)s were analyzed using an inductively coupled plasma mass spectrometry (ICP-MS). Mean concentrations (mg/kg as dry weight) of metal(loid)s (n=45) across all rice types were found in the order of Fe (41.37)>Cu (6.51)>Cr (1.91)>Ni (0.38)>As (0.35)>Se (0.07)>Cd (0.03)>Co (0.02). Thirty-three percent and none of the rice samples surpassed, respectively, the FAO/WHO recommended limits of As and Cd. This study revealed that rice could be a primary exposure pathway to toxic metal(loid)s, leading to either noncarcinogenic or carcinogenic health problems. The non-carcinogenic health risk was mainly associated with As which contributed 63% to the hazard index followed by Cr (34%), Cd (2%), and Ni (1%). The carcinogenic risk to adults was high (>10-4) for As, Cr, Cd, and Ni. The cancer risk (CR) for each element was 5 to 8 times higher than the upper limit of cancer risk for an environmental carcinogen (<10-4). The findings from this study could provide the metal(loid)s pollution status of various types of rice which are beneficial to relevant authorities in addressing food safety and security-related issues.
    MeSH terms: Adult; Cadmium/analysis; China; Chromium/analysis; Cobalt/analysis; Environmental Monitoring; Humans; Malaysia; Neoplasms*; Nickel/analysis; Oryza*; Risk Assessment
  15. Yeung KHT, Kim E, Yap WA, Pathammavong C, Franzel L, Park YL, et al.
    BMC Med, 2023 Jul 10;21(1):248.
    PMID: 37424001 DOI: 10.1186/s12916-023-02944-1
    BACKGROUND: The COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool was developed to assist countries to estimate incremental financial costs to roll out COVID-19 vaccines. This article describes the purposes, assumptions and methods used in the CVIC tool and presents the estimated financial costs of delivering COVID-19 vaccines in the Lao People's Democratic Republic (Lao PDR).

    METHODS: From March to September 2021, a multidisciplinary team in Lao PDR was involved in the costing exercise of the National Deployment and Vaccination Plan for COVID-19 vaccines to develop potential scenarios and gather inputs using the CVIC tool. Financial costs of introducing COVID-19 vaccines for 3 years from 2021 to 2023 were projected from the government perspective. All costs were collected in 2021 Lao Kip and presented in United States dollar.

    RESULTS: From 2021 to 2023, the financial cost required to vaccinate all adults in Lao PDR with primary series of COVID-19 vaccines (1 dose for Ad26.COV2.S (recombinant) vaccine and 2 doses for the other vaccine products) is estimated to be US$6.44 million (excluding vaccine costs) and additionally US$1.44 million and US$1.62 million to include teenagers and children, respectively. These translate to financial costs of US$0.79-0.81 per dose, which decrease to US$0.6 when two boosters are introduced to the population. Capital and operational cold-chain costs contributed 15-34% and 15-24% of the total costs in all scenarios, respectively. 17-26% went to data management, monitoring and evaluation, and oversight, and 13-22% to vaccine delivery.

    CONCLUSIONS: With the CVIC tool, costs of five scenarios were estimated with different target population and booster dose use. These facilitated Lao PDR to refine their strategic planning for COVID-19 vaccine rollout and to decide on the level of external resources needed to mobilize and support outreach services. The results may further inform inputs in cost-effectiveness or cost-benefit analyses and potentially be applied and adjusted in similar low- and middle-income settings.

    MeSH terms: Adolescent; Adult; Child; Cost-Benefit Analysis; Humans; Laos/epidemiology
  16. Arshed M, Zakar R, Umer MF, Kiran M, Ullah N, Iftikhar G, et al.
    Trials, 2023 Jul 10;24(1):448.
    PMID: 37424031 DOI: 10.1186/s13063-023-07472-0
    BACKGROUND: Hypertension is a highly relevant public health challenge. Digital interventions may support improving adherence to anti-hypertensive medications and alter health behavior. Therefore, this protocol describes a study that aims to assess the effectiveness of mHealth and educational support through peer counseling (Ed-counselling) to control blood pressure in hypertensive patients when compared to standard care.

    METHODS: We chose a double-blinded pragmatic randomized-controlled with factorial design for this investigation. The trial is going to recruit 1648 hypertensive patients with coronary artery disease at the age of 21 to 70 years. All participants will already be on anti-hypertensive medication and own a smartphone. They will be randomized into four groups with each having 412 participants. The first group will only receive standard care; while the second group, in addition to standard care, will receive monthly Ed-counselling (educational booklets with animated infographics and peer counseling); the third group will receive daily written and voice reminders and an education-led video once weekly together with standard care; while the fourth one gets both interventions given to second and third groups respectively. All groups will be followed-up for 1 year (0, 6, and 12 months). The primary outcome will be the change in systolic blood pressure while secondary outcomes include health-related quality of life and changes in medication adherence. For measuring changes in systolic blood pressure (SBP) and adherence scores difference at 0, 6, and 12 months between and within the group, parametric (ANOVA/repeated measure ANOVA) and non-parametric tests (Kruskal-Wallis test/Friedman test) will be used. By using the general estimating equation (GEE) with negative binomial regression, at 12 months, the covariates affecting primary and secondary outcomes will be determined and controlled. The analysis will be intention-to-treat. All the outcomes will be analyzed at 0, 6, and 12 months; however, the final analysis will be at 12 months from baseline.

    DISCUSSION: Besides adding up to existing evidence in the literature on the subject, our designed modules using mHealth technology can help in reducing hypertension-related morbidity and mortality in developing countries.

    MeSH terms: Adult; Aged; Antihypertensive Agents/adverse effects; Counseling; Humans; Middle Aged; Pakistan; Quality of Life; Randomized Controlled Trials as Topic; Medication Adherence; Young Adult
  17. Liu Y, Marshall NM, Yu SS, Kim W, Gao YG, Robinson H, et al.
    Inorg Chem, 2023 Jul 24;62(29):11618-11625.
    PMID: 37424080 DOI: 10.1021/acs.inorgchem.3c01365
    In order to investigate the effects of the secondary coordination sphere in fine-tuning redox potentials (E°') of type 1 blue copper (T1Cu) in cupredoxins, we have introduced M13F, M44F, and G116F mutations both individually and in combination in the secondary coordination sphere of the T1Cu center of azurin (Az) from Pseudomonas aeruginosa. These variants were found to differentially influence the E°' of T1Cu, with M13F Az decreasing E°', M44F Az increasing E°', and G116F Az showing a negligible effect. In addition, combining the M13F and M44F mutations increases E°' by 26 mV relative to WT-Az, which is very close to the combined effect of E°' by each mutation. Furthermore, combining G116F with either M13F or M44F mutation resulted in negative and positive cooperative effects, respectively. Crystal structures of M13F/M44F-Az, M13F/G116F-Az, and M44F/G116F-Az combined with that of G116F-Az reveal these changes arise from steric effects and fine-tuning of hydrogen bond networks around the copper-binding His117 residue. The insights gained from this study would provide another step toward the development of redox-active proteins with tunable redox properties for many biological and biotechnological applications.
    MeSH terms: Copper/chemistry; Models, Molecular; Mutation; Oxidation-Reduction; Phenylalanine/chemistry; Pseudomonas aeruginosa/chemistry
  18. Looi JC, Allison S, Woon L
    Australas Psychiatry, 2023 Oct;31(5):659-661.
    PMID: 37424206 DOI: 10.1177/10398562231188264
    OBJECTIVE: Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors' clinical experience and the existing research literature.

    CONCLUSIONS: There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist's assessment of the temporary role, and consideration of the local service conditions.

    MeSH terms: Humans; Inpatients; Peer Group; Psychiatry*
  19. Wan Ismail WFNB, Bin Wan Sulaiman WA, Saad AZBM, Mokthar AMB, Paiman MB, Jusoh MHB, et al.
    Microsurgery, 2023 Oct;43(7):722-729.
    PMID: 37424321 DOI: 10.1002/micr.31086
    Replantation of amputated limbs after long ischemic hours almost always comes with reperfusion syndrome and poor outcomes. An ischemic time of greater than 6 h is often considered unsuitable for major limb replantation. However, usage of extracorporeal perfusion has been shown to prolong the viability of major limbs in animal studies. The aim of this report is to show that extracorporeal perfusion with cardiopulmonary bypass machine (CPBM) is a safe and reliable technique in improving limb survival as illustrated by our cases. We report two cases of successful major limb replantation with late presentation. One case involved a 31-year-old man with shoulder disarticulation and the other involved a 30-year-old man sustained proximal transtibial amputation. Both patients, who were generally fit, were involved in major road traffic accidents. The amputated segments were connected to a CPBM to expedite reperfusion and to flush away anaerobic metabolic products. The major vessels were cannulated and connected to a bypass machine that was initially primed with heparinized saline and perfused with packed cells at 100% oxygen concentration. The perfusion was carried out at 35°C with low pressure to prevent edema and low flow to reduce reperfusion injury. Venous blood was drained completely before replantation. Total ischemia times were 7 h 40 min and 9 h, respectively. No evidences of perioperative reperfusion syndrome were seen. Both of the replanted limbs survived and patients had regained better-than-expected limb functional outcomes at 5-year and 2-year follow-up, respectively. CPBM may be safely used in major replantation surgery to enhance limb survival and therefore warrants further research.
  20. Asadi K, Tehrany PM, Salari A, Ghorbani Vajargah P, Mollaei A, Sarafi M, et al.
    Int Wound J, 2023 Dec;20(10):4349-4363.
    PMID: 37424390 DOI: 10.1111/iwj.14300
    The goal of this systematic review and meta-analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Prevalence", "Surgical wound infection", "Surgical site infection" and "Orthopedics" from the earliest to the May 1, 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%-7.2%; I2  = 99.39%; p 
    MeSH terms: Cross-Sectional Studies; Diabetes Mellitus*; Female; Humans; Male; Surgical Wound Infection/epidemiology; Prevalence; Orthopedic Procedures*
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