Browse publications by year: 2023

  1. Maspero J, De Paula Motta Rubini N, Zhang J, Sanclemente G, Amador JR, El Sayed MH, et al.
    World Allergy Organ J, 2023 Mar;16(3):100724.
    PMID: 37033301 DOI: 10.1016/j.waojou.2022.100724
    BACKGROUND: There are gaps in our understanding of the epidemiology of atopic dermatitis (AD) in adults.

    OBJECTIVE: To evaluate the prevalence and severity of AD in adults from countries/regions within Asia, Eurasia, Latin America, Middle East, and Russia.

    METHODS: This international, web-based survey was performed in Argentina, Brazil, China, Colombia, Egypt, Hong Kong, Israel, Malaysia, Mexico, Russia, Kingdom of Saudi Arabia (KSA), Singapore, Taiwan, Thailand, Turkey, and United Arab Emirates. Questionnaires were sent to adult members of online respondent panels for determination of AD and assessment of severity. A diagnosis of AD required respondents to meet the modified United Kingdom (UK) Working Party criteria and to self-report they had a physician diagnosis of AD. Severity of AD was determined using Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), and Patient Global Assessment (PGA).

    RESULTS: Among respondents by country/region the prevalence of AD ranged from 3.4% in Israel to 33.7% in Thailand. The prevalence was generally higher in females versus males. Severity varied by scale, although regardless of scale the proportion of respondents with mild and moderate disease was higher than severe disease. PGA consistently resulted in the lowest proportion of severe AD (range 2.4% China - 10.8% Turkey) relative to PO-SCORAD (range 13.4% China - 41.6% KSA) and POEM (range 5.1% China - 16.6% Israel).

    CONCLUSIONS: This survey highlights the importance of AD in adults, with high prevalence and high morbidity among respondents and emphasizes that AD is not just a disease of childhood-there is disease persistence and chronicity in adults.

  2. Suhaidi NA, Halmi MIE, Rashidi AA, Anuar MFM, Mahmud K, Kusnin N, et al.
    3 Biotech, 2023 May;13(5):121.
    PMID: 37033387 DOI: 10.1007/s13205-023-03532-z
    A very sensitive and selective colorimetric biosensor for the measurement of mercury ion (Hg2+) in environmental samples has been developed using functionalized gold nanoparticles with bromelain enzyme (brn-AuNPs). This work has shown that Hg2+ measurement based on spectrophotometer and digital image analysis is a very innovative and successful method for providing an effective preliminary system and has promise for the future of water quality biomonitoring. Response Surface Methodology (RSM), a Box-Behnken design-based technique, was used to identify the optimum levels of functionalization of bromelain to AuNPs. The created model's validity was confirmed, and statistical analysis revealed that the ideal functionalize conditions were 1 mM of AuNPs, functionalize with 0.59 mM bromelain concentration on 14 ℃ temperature and 72 h incubation time. The lowest colorimetric detection concentration (LOD) of brn-AuNPs of Hg2+ was 0.0092 ppm and 0.011 ppm for spectrophotometer and digital image analysis. As shown, digital image analysis had advantages based on the LOD result comparable to UV-VIS spectrophotometer. The practical application of the brn-AuNPs sensing was proven with mercury determination in water samples. The present study developed a robust sensor, which successfully implemented in a compact portable sensor kit, turning this sensor into a very potent tool for the development water quality biomonitoring system of Hg2+ application.
  3. Singh R, Rehman AU, Ahmed T, Ahmad K, Mahajan S, Pandit AK, et al.
    Inform Med Unlocked, 2023;38:101235.
    PMID: 37033412 DOI: 10.1016/j.imu.2023.101235
    In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when R 0 < 1 and unstable when R 0 > 1 . The global stability of the endemic point is analysed by constructing the Lyapunov function. The dynamic stability also exhibits bifurcation behaviour. The optimal control theory is used to find an optimal solution to the problem in the mathematical model. The sensitivity analysis is performed to clarify the effective parameters which affect the reproduction number the most. Numerical simulation is carried out to assess the effect of various biological parameters in the dynamic of both tuberculosis and COVID-19 classes. Our simulation results show that the COVID-19 and TB infections can be mitigated by controlling the transmission rate γ .
  4. Varathan V, Mat Baki M, Kalimuthu S
    Cureus, 2023 Mar;15(3):e35863.
    PMID: 37033535 DOI: 10.7759/cureus.35863
    A laryngeal cyst is usually benign. The most common site origin of a cyst in the larynx is the lingual surface of the epiglottis. Epiglottic cysts are rare. Usually, it is asymptomatic in patients and can be treated conservatively if the size is small. Airway obstruction is very rare but could be life-threatening. If there is airway obstruction, the cyst should be removed immediately. Early detection and immediate management lead to favorable outcomes. A multidisciplinary-team approach with the ENT and anesthetic inputs are essential when dealing with the current condition. This case report highlights the management of such a patient who presented with airway obstruction due to an epiglottic cyst.
  5. Chee SF, Chew CF, Zunaina E
    Cureus, 2023 Mar;15(3):e35823.
    PMID: 37033552 DOI: 10.7759/cureus.35823
    Background To analyze the etiology of optic disc swelling (ODS) and compare the clinical features between non-arteritic anterior ischemic optic neuropathy (NA-AION) and optic neuritis (ON) at our center from January 2019 to January 2020. Methodology Clinical records of all patients who presented with ODS between January 2019 and January 2020 were reviewed. The collected data were analyzed using IBM SPSS Statistics for Windows (Version 23.0, IBM Corp., Armonk, NY, USA). Results A total of 70 eyes among 47 patients were included in this review. There were 24 patients (51%) who had unilateral ODS, while 23 patients (49.0%) had bilateral ODS. The most common etiology of unilateral ODS was ON (45.7%), NA-AION (25%), and neuroretinitis (12.5%). Among bilateral ODS, the most common cause was papilledema (30.4%), hypertensive retinopathy (21.7%), diabetic papillitis (13.1%), and optic disc drusen (13.1%). Among unilateral ODS, the mean onset age was significantly older in NA-AION cases than that in ON cases (57.5 years vs. 40.3 years, P = 0.016). Ocular pain was a significant clinical finding observed in ON cases (54.5%) and none in NA-AION cases (P = 0.043). Although there was no significant difference in the initial visual acuity (VA) between NA-AION and ON, the final VA was significantly improved in ON compared to NA-AION (0.31 ± 0.34 vs. 1.14 ± 1.00, P = 0.029). Conclusions Many differential diagnoses must be considered when a patient is presented with ODS. With the increased prevalence of hypertension and diabetes in Malaysia, it is not a surprise that both hypertensive retinopathy and diabetic papillitis together accounted for one-third of the bilateral ODS patients.
  6. Islam MT, Martorell M, González-Contreras C, Villagran M, Mardones L, Tynybekov B, et al.
    Front Pharmacol, 2023;14:1099380.
    PMID: 37033617 DOI: 10.3389/fphar.2023.1099380
    Alternariol is a toxic metabolite of Alternaria fungi and studies have shown multiple potential pharmacological effects. To outline the anticancer effects and mechanisms of alternariol and its derivatives based on database reports, an updated search of PubMed/MedLine, ScienceDirect, Web of Science, and Scopus databases was performed with relevant keywords for published articles. The studies found to suggest that this mycotoxin and/or its derivatives have potential anticancer effects in many pharmacological preclinical test systems. Scientific reports indicate that alternariol and/or its derivatives exhibit anticancer through several pathways, including cytotoxic, reactive oxygen species leading to oxidative stress and mitochondrial dysfunction-linked cytotoxic effect, anti-inflammatory, cell cycle arrest, apoptotic cell death, genotoxic and mutagenic, anti-proliferative, autophagy, and estrogenic and clastogenic mechanisms. In light of these results, alternariol may be one of the hopeful chemotherapeutic agents.
  7. Abdol Jani WNF, Suja' F, Sayed Jamaludin SI, Mohamad NF, Abdul Rani NH
    Bioinorg Chem Appl, 2023;2023:4011670.
    PMID: 37033717 DOI: 10.1155/2023/4011670
    An effective recovery technology will be valuable in the future because the concentration of the precious metal contained in the source can be a key driver in recycling technology. This study aims to use response surface methodology (RSM) through Minitab software to discover the optimum oxygen level (mgL-1), e-waste pulp density (% w/v), and glycine concentration (mgL-1) for the maximum recovery of gold (Au) and silver (Ag). The method of precious metals recovery used for this study was taken from the bioleaching using 2 L of batch stirred tank reactor (BSTR). A Box-Behnken of RSM experimental statistical designs was used to optimize the experimental procedure. The result of the RSM optimization showed that the highest recovery was achieved at an oxygen concentration of 0.56 mgL-1, a pulp density of 1.95%, and a glycine concentration of 2.49 mgL-1, which resulted in the recovery of 62.40% of Au. The pulp density and glycine concentration greatly impact how much Au is bioleached by C. violaceum. As a result, not all of the variables analyzed seem crucial for getting the best precious metals recovery, and some adjustments may be useful in the future.
  8. Rozaimi R, Shu-Chien AC, Wang Y, Sutikno S, Ikhwanuddin M, Shi X, et al.
    PeerJ, 2023;11:e15143.
    PMID: 37033733 DOI: 10.7717/peerj.15143
    Asymmetric body traits in bilateral organisms are common and serve a range of different functions. In crustaceans, specifically among brachyuran crabs, heterochely and handedness in some species are known to aid in behavioural responses such as food acquisition, and sexual and territorial displays. However, the heterochely of the intertidal mud crab genus Scylla is still poorly understood. This study investigated the cheliped morphometric characteristics of orange mud crab Scylla olivacea and the relation of heterochely and handedness to sex. Scylla olivacea is heterochelous, with predominant right-handed (70.2%). Three morphometric variables, i.e., propodus length (PL), propodus depth (PD), and propodus width (PW) were significantly larger in the right cheliped and the estimated handedness based on these three variables were consistent with the presence of molariform teeth. The effect of sex had no influence on the occurrence of heterochely or handedness. The frequency of left-handedness increased with size, especially in males. We postulate that handedness reversal, a phenomenon seen in other crab species when the dominant hand is lost, also occurs in S. olivacea, thereby resulting in a change in left-handedness frequency. The use of chelipeds by males in mate and territorial defenses might provide an explanation for the higher risk of losing a dominant cheliped and thus, higher left-handedness frequency compared to females. Future behavioural research could shed light on the selective forces that affect the handedness distribution in mud crabs. Knowledge on heterochely and handedness of mud crabs could be useful for future development of less aggressive crab populations by claw reversal and the optimisation of limb autotomy techniques.
    MeSH terms: Aggression; Animals; Brachyura*; Extremities; Female; Functional Laterality; Male; Reproduction
  9. Thye KL, Wan Abdullah WMAN, Ong-Abdullah J, Lamasudin DU, Wee CY, Mohd Yusoff MHY, et al.
    Physiol Mol Biol Plants, 2023 Mar;29(3):377-392.
    PMID: 37033764 DOI: 10.1007/s12298-023-01293-w
    Utilisation of calcium lignosulfonate (CaLS) in Vanilla planifolia has been reported to improve shoot multiplication. However, mechanisms responsible for such observation remain unknown. Here, we elucidated the underlying mechanisms of CaLS in promoting shoot multiplication of V. planifolia via comparative proteomics, biochemical assays, and nutrient analysis. The proteome profile of CaLS-treated plants showed enhancement of several important cellular metabolisms such as photosynthesis, protein synthesis, Krebs cycle, glycolysis, gluconeogenesis, and carbohydrate synthesis. Further biochemical analysis recorded that CaLS increased Rubisco activity, hexokinase activity, isocitrate dehydrogenase activity, total carbohydrate content, glutamate synthase activity and total protein content in plant shoot, suggesting the role of CaLS in enhancing shoot growth via upregulation of cellular metabolism. Subsequent nutrient analysis showed that CaLS treatment elevated the contents of several nutrient ions especially calcium and sodium ions. In addition, our study also revealed that CaLS successfully maintained the cellular homeostasis level through the regulation of signalling molecules such as reactive oxygen species and calcium ions. These results demonstrated that the CaLS treatment can enhance shoot multiplication in V. planifolia Andrews by stimulating nutrient uptake, inducing cell metabolism, and regulating cell homeostasis.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12298-023-01293-w.

  10. Ullah A, Khan AS, Sarker MR, Iqbal MJ, Khan HU, Tirth V, et al.
    ACS Omega, 2023 Apr 04;8(13):12372-12378.
    PMID: 37033827 DOI: 10.1021/acsomega.3c00128
    The low-temperature sintering of (Bi0.5Na0.5)TiO3-based ceramics can be achieved by sintering aid CuO. Piezoelectric ceramics (1 - x)[0.90(Bi0.5Na0.5)TiO3 - 0.10SrTiO3] - xCuO (BNT-ST-Cu) with x = 0, 0.01, 0.02, 0.03, and 0.04 were prepared through the mixed oxide route. A tetragonal structure was indexed for the undoped sample. Its structure was found to be changed to a pseudocubic when Cu was added. For undoped Cu samples, the sintering temperature (T s) for sufficient densification was 1160 °C. However, T s was reduced to 1090-1120 °C for Cu-added specimens. Field emission scanning electron microscopy (FE-SEM) showed a uniform and dense grain morphology for all samples. The maximum dielectric constant temperature (T m) was decreased with the doping concentration of Cu and applied frequency. The strain was increased with Cu concentration and had the maximum value of 500 pm/V for the sample x = 0.02 with symmetric and slim strain loops.
  11. Radhakrishnan PJ, Raghunath SP, Mohan D, Rajan R, Iype T
    Ann Indian Acad Neurol, 2023;26(1):44-53.
    PMID: 37034046 DOI: 10.4103/aian.aian_695_22
    BACKGROUND: Many neuropsychological tests are primarily developed in high-income countries, and normative data are not readily available for low- and middle-income countries (LMICs). We need culturally appropriate cognitive screening tests for India.

    OBJECTIVE: Hence, we decided to translate the Hindi cognitive screening test battery (HCSTB) tool to Malayalam and establish the age and education-stratified norms for a Malayalam cognitive screening test battery (MCSTB).

    MATERIAL AND METHODS: HCSTB was translated to Malayalam, back-translated by bilinguals conversant in Malayalam and English, and pretested on 30 older normal adults. Using a multistage sampling technique, we conducted a descriptive cross-sectional survey in the Thiruvananthapuram district of Kerala, India. We approached older adults aged ≥60 years for informed and written consent. We excluded subjects with depression, functional impairment, cognitive impairment, history of stroke, psychosis, and visual/hearing loss that impaired cognitive assessment.

    RESULTS: The normative data were derived from 441 older adults: 226 (51%) from rural areas and 215 (49%) from urban areas. Age and education affected the cognitive scores. The time to administer MCSTB among normal adults was approximately 17 minutes.

    DISCUSSION AND CONCLUSION: The derived normative data showed lower values than the published literature. A limitation of our study was the small number of older people with ≥12 years of education and the lack of neuroimaging of the subjects.

  12. Azhar NA, Abu Bakar SA, Citartan M, Ahmad NH
    World J Hepatol, 2023 Mar 27;15(3):393-409.
    PMID: 37034237 DOI: 10.4254/wjh.v15.i3.393
    BACKGROUND: The demand for the development of cancer nanomedicine has increased due to its great therapeutic value that can overcome the limitations of conventional cancer therapy. However, the presence of various bioactive compounds in crude plant extracts used for the synthesis of silver nanoparticles (AgNPs) makes its precise mechanisms of action unclear.

    AIM: To assessed the mRNA transcriptome profiling of human HepG2 cells exposed to Catharanthus roseus G. Don (C. roseus)-AgNPs.

    METHODS: The proliferative activity of hepatocellular carcinoma (HepG2) and normal human liver (THLE3) cells treated with C. roseusAgNPs were measured using MTT assay. The RNA samples were extracted and sequenced using BGIseq500 platform. This is followed by data filtering, mapping, gene expression analysis, differentially expression genes analysis, Gene Ontology analysis, and pathway analysis.

    RESULTS: The mean IC50 values of C. roseusAgNPs on HepG2 was 4.38 ± 1.59 μg/mL while on THLE3 cells was 800 ± 1.55 μg/mL. Transcriptome profiling revealed an alteration of 296 genes. C. roseusAgNPs induced the expression of stress-associated genes such as MT, HSP and HMOX-1. Cellular signalling pathways were potentially activated through MAPK, TNF and TGF pathways that are responsible for apoptosis and cell cycle arrest. The alteration of ARF6, EHD2, FGFR3, RhoA, EEA1, VPS28, VPS25, and TSG101 indicated the uptake of C. roseus-AgNPs via both clathrin-dependent and clathrin-independent endocytosis.

    CONCLUSION: This study provides new insights into gene expression study of biosynthesised AgNPs on cancer cells. The cytotoxicity effect is mediated by the aberrant gene alteration, and more interestingly the unique selective antiproliferative properties indicate the C. roseusAgNPs as an ideal anticancer candidate.

  13. Nordin NA, Haris SN, Hamid SBA
    PMID: 37034863 DOI: 10.4103/jehp.jehp_744_22
    BACKGROUND: Nutrition is essential for schoolchildren to reach their full potential psychologically and cognitively. Malnutrition, which is prevalent among aboriginal schoolchildren in Malaysia, can interfere their learning and academic performance. Developing a module to be used during a school-based nutritional intervention program is essential to ensuring that students develop healthy eating habits and lifestyles. Thus, this study aims to develop and validate nutrition education module focusing on aboriginal schoolchildren for the eat right future bright (ERFB) nutrition education program.

    MATERIALS AND METHODS: This cross-sectional study was conducted in three steps: Step 1: development of module based on literature reviews, Step 2: content and face validation of the module by the expert panels, and Step 3: face validation of the module by target users. This study has used the validation form proposed by de Castro. This form consists of seven aspects, two aspects related to content validity and another four aspects related to face validity. A content validity index (CVI) was used to analyze the content validity. Two formulas were used to calculate CVI, which were I-CVI and S-CVI. Meanwhile, the data for module's face used the level of agreement.

    RESULTS: Both I-CVI and S-CVI obtained more than 0.78 and 0.80, respectively, which indicate that the module has good content validity. Moreover, for face validity, the total of agreement from expert panels and target users was more than 75%, which is considered face validated.

    CONCLUSIONS: In conclusion, the module that has been developed has good content validity and can be used by teachers in teaching appropriate nutrition knowledge to aboriginal primary schoolchildren.

  14. Chun TW, Yunus MM
    Front Psychol, 2023;14:1127272.
    PMID: 37034902 DOI: 10.3389/fpsyg.2023.1127272
    This study aimed to investigate English as a Second Language (ESL) teachers' technology acceptance levels and to identify the factors affecting their behavioral intentions (BI) with respect to technology use in the post-COVID-19 era. A cross-sectional survey of 361 Malaysian ESL teachers was conducted. Participants were recruited via convenience sampling, and they answered an online survey questionnaire that was designed with reference to past studies. The collected data were analyzed via descriptive statistics, Pearson's correlation, and multiple regression analyses. The findings revealed that Malaysian ESL teachers generally had a high level of technology acceptance in the post-COVID-19 era. Their BIs had a significant relationship with three factors: performance expectancy (PE), effort expectancy (EE), and social influence (SI), of which EE was identified as the most significant factor influencing their BI with respect to technology use in the post-COVID-19 era. Conversely, the presence of facilitating conditions did not have a substantial connection with ESL teachers' behavioral intentions for technology use after the pandemic, despite the fact that there was weak positive relationship with each other. This study provides insights for the field of educational psychology by identifying the current trends in ESL teachers' behavioral intentions in adopting technology in the post-COVID-19-era ESL classrooms. The findings of this study may also support investigations into technology acceptance in ESL teaching, illustrating a growing need to provide adequate educational and technological tools, resources, and facilities to facilitate the delivery of lessons by ESL teachers. Future studies should conduct longitudinal research and investigate more variables from different technology acceptance models.
  15. Xiang M, Soh KG, Xu Y, Ahrari S, Zakaria NS
    Front Psychol, 2023;14:1129961.
    PMID: 37034921 DOI: 10.3389/fpsyg.2023.1129961
    INTRODUCTION: Many scholars have explored the participation of LGBTQ individuals in sports. However, these studies have either categorized homosexuality and bisexuality together or focused only on lesbian, gay, or transgender individuals. There is a lack of research in the literature on bisexual individuals' sports participation and an even more significant lack of Asia perspectives. Therefore, this qualitative study is aimed to explore the experiences of female bisexual student-athletes in China.

    METHODS: Semi-structured interviews with four female bisexual student-athletes were conducted and analyzed using Interpretative Phenomenological Analysis (IPA).

    RESULTS: Three themes and eight sub-themes were identified. Theme 1. what bisexual identity means, and sub-themes: a struggling journey, emotional attraction, and gender role for female bisexual student-athletes; Theme 2. invalid identity, and sub-themes: lesbian mask, unrecognized identity; Theme 3. perceptions of sports context, and sub-themes: the influence of the sports context on sexual fluidity, relative inclusion, and perceived rejection.

    CONCLUSION: This study provides new insights into understanding the experience of female bisexual student-athlete. In addition, the results highlight the importance of the need to study bisexuality as a distinct identity.

  16. Sazali NB, Chan LW, Wong TW
    Asian J Pharm Sci, 2023 Mar;18(2):100794.
    PMID: 37035131 DOI: 10.1016/j.ajps.2023.100794
    Nanoscale medicine confers passive and active targeting potential. The development of nanomedicine is however met with processing, handling and administration hurdles. Excessive solid nanoparticle aggregation and caking result in low product yield, poor particle flowability and inefficient drug administration. These are overcome by converting the nanoparticles into a microscale dosage form via agglomeration or compaction techniques. Agglomeration and compaction nonetheless predispose the nanoparticles to risks of losing their nanogeometry, surface composition or chemistry being altered and negating biological performance. This study reviews risk factors faced during agglomeration and compaction that could result in these changes to nanoparticles. The potential risk factors pertain to materials choice in nanoparticle and microscale dosage form development, and their interplay effects with process temperature, physical forces and environmental stresses. To render the physicochemical and biological behaviour of the nanoparticles unaffected by agglomeration or compaction, modes to modulate the interplay effects of material and formulation with processing and environment variables are discussed.
  17. Abdullah N, Rizuana IH, Goh JHL, Lee QZ, Md Isa N, Md Pauzi SH
    Front Oncol, 2023;13:1034556.
    PMID: 37035170 DOI: 10.3389/fonc.2023.1034556
    A 57-year-old Malay nullipara initially presented with a right breast lump that was increasing in size but defaulted follow-up. Two years later, she developed a contralateral breast lump. She only returned to the hospital when the right breast lump had become painful, 4 years from its onset. The biopsy of the right breast lump was a phylloides tumor and that of the left breast lump was a carcinoma. She had bilateral palpable axillary lymph nodes. She underwent bilateral mastectomy and axillary dissection. The pathology report confirmed the right breast lesion to be a malignant phylloides and the left breast lesion to be a carcinoma (pT3N2). She declined adjuvant treatment. A year after the surgical operation of the metachronous lesions, she had a right chest wall recurrence with widespread pulmonary metastases. She was given palliative chemotherapy but succumbed several months later.
  18. Zulaziz N, Chai SJ, Lim KP
    Front Oncol, 2023;13:1151373.
    PMID: 37035187 DOI: 10.3389/fonc.2023.1151373
    Hepatocellular carcinoma (HCC) is the most common form of liver cancer. It is often preceded by chronic inflammation such as liver fibrosis and cirrhosis. Different cell types are believed to give rise to liver-specific cancer associated fibroblast (CAF), these include resident fibroblast, hepatic stellate cell, liver cancer cell, hepatic sinusoidal endothelial cell and mesenchymal stromal cell. The abundance of fibroblasts has contributed to the cancer progression, immune modulation and treatment resistance in HCC. In this review, we discussed the origins, subtypes and roles of cancer associated fibroblasts in HCC. Their specific roles in shaping the tumor microenvironment, facilitating cancer growth, and modulating different immune cell types to confer a permissive environment for cancer growth. CAF is now an attractive therapeutic target for cancer treatment, however specific therapeutic development in HCC is still lacking. Hence, we have included preclinical and clinical development of CAF-specific interventions for other cancer types in this review. However, most CAF-specific therapies have resulted in disappointing clinical outcomes, likely due to the difficulties in differentiating CAF from normal fibroblast. A thorough understanding of the characteristics and functionalities of CAF is warranted to further improve the therapeutic efficacy of anti-CAF therapies.
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