Browse publications by year: 2024

  1. Xiao ZS, Zhou H, Jiang YL, Samah NA
    World J Psychiatry, 2024 Dec 19;14(12):1793-1796.
    PMID: 39704369 DOI: 10.5498/wjp.v14.i12.1793
    This article examines the critical integration of reflexivity, cultural sensitivity, and emergent design in qualitative psychiatry research focused on lived experiences. While quantitative methods offer essential clinical insights, qualitative approaches provide a deeper understanding of the emotional, psychological, and social dimensions of mental health. Reflexivity enables researchers to remain aware of how their personal biases and professional backgrounds shape data interpretation. Cultural sensitivity ensures that mental health conditions are understood within their broader cultural contexts, helping avoid misrepresentation and promoting authentic participant expression. Emergent design offers flexibility in adapting the research process to evolving themes, particularly in the dynamic and multifaceted realm of psychiatric conditions. Together, these principles promote ethically sound, participant-centered research that captures the full complexity of lived experiences. The article also highlighted the practical implications of these principles for enhancing both academic knowledge and clinical practice in psychiatry.
  2. Alwehaidah MS, Al-Awadhi R, AlRoomy M, Baqer TA
    Mol Genet Genomics, 2024 Dec 20;300(1):2.
    PMID: 39704849 DOI: 10.1007/s00438-024-02207-5
    OBJECTIVE: . Despite the establishment of a link between telomere status and carcinogenesis, lack of a consensus in the cancer specific pattern of telomere length has a severe impact on the use of relative telomere length (RTL) in cancer diagnosis. The disparity in assessing the relationship between telomere length and cancer risk is complex and may vary as it is influenced by other factors. The objective of this study is to thoroughly examine the intricate relationship between telomere length and cancer incidence in Papillary Thyroid Cancer (PTC) depending on the tumor type, stage, patients' sex and age. Therefore, the current study is focused on the association of RTL in PTC patients with different clinicopathological characteristics and compared with controls to determine the risk of PTC and expected survival time after surgery.

    METHOD: . This study included 126 patients with PTC and 80 controls. RTL in thyroid tissues was measured using quantitative (q) PCR. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis. Kaplan-Meier and Cox regression were used to analyze postsurgical outcomes.

    RESULT: . The RTL of patients was significantly shorter than that of controls. A short RTL was significantly correlated with an elevated risk of PTC in patients aged ≥ 55 years, female sex, classic subtype, and tumor size > 2 cm. A short RTL did not affect the overall survival of patients with PTC; however, it was associated with poor survival in patients with tumor size > 2 cm and tumor invasion.

    CONCLUSION: . This unique study combines the use of RTL with various clinicopathological features of patients with PTC. In conclusion, RTL is a promising tumor marker that correlates with the clinical characteristics of patients with PTC. Specifically, RTL  2 cm and tumor invasion to predict the risk of PTC development and prognosis of the disease. This study will open new horizon in the use of molecular marker such as RTL for understanding its association with increased cancer risk in patients with different clinicopathological features.

    MeSH terms: Adult; Aged; Female; Humans; Male; Middle Aged; Prognosis; Case-Control Studies; Risk Assessment/methods; Kaplan-Meier Estimate; Telomere Homeostasis/genetics
  3. Zafar R, Rehman IU, Shah Y, Ming LC, Hadi MA, Suleiman AK, et al.
    Medicine (Baltimore), 2024 Dec 20;103(51):e41004.
    PMID: 39705490 DOI: 10.1097/MD.0000000000041004
    Pharmacists, as an integral part of the healthcare team, can play a crucial role in preventing drug-related problems in patients with chronic kidney disease that arise due to inappropriate doses. This study aimed to develop and validate a new tool, the renal dosing questionnaire (RDQ-13), for pharmacists working across hospital, community, and retail pharmacy settings. A cross-sectional study was conducted from January to March 2023 among pharmacists working in different settings. The RDQ-13 scale consists of 3-sections, encompassing demographic details, a knowledge section with 6 domains, each having 4 questions with the choice of "yes/no," an attitude section featuring a Likert scale for 4 items, and a perception section featuring a Likert scale for 3 items. The assessment of construct and discriminative validity was performed along with testing for reliability. The average variance extracted value and the composite reliability value were used for convergent validity. A total of 65 pharmacists completed the RDQ-13, but at retest n = 2 participants were dropped (response rate at retest was 96.9%). Exploratory factor analysis revealed 3-factor loadings with 59.1% of the variance, whereas the Kaiser-Mayer-Olkin value was 0.60. The Cronbach alpha value of 0.700 indicates good internal consistency, whereas the intraclass correlation coefficient (ICC) for the test and retest showed that most domains/scores were statistically significant (P 
    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pharmacists*; Psychometrics/methods; Surveys and Questionnaires/standards; Reproducibility of Results; Renal Insufficiency, Chronic*
  4. Low TQ, Teerawichitchainan B, Mansor N
    Res Aging, 2024 Dec 20.
    PMID: 39705713 DOI: 10.1177/01640275241309076
    With Asia's rapid population aging, intergenerational exchanges between older adults and children are becoming increasingly important for old-age support. However, the relationship between older adults' marital quality and intergenerational support remains underexplored, particularly in multi-ethnic and developing settings. To address this, we examine a subsample of currently married older adults (60+) with at least one child (n = 1575) from Wave 1 (2018) of the Malaysian Aging and Retirement Survey. Using latent class analysis, we identify intergenerational support patterns among older Malaysians. Multinomial logistic regression is employed to investigate how older adults' marital experiences relate to these support patterns. Findings show positive marital experiences are associated with support patterns involving mutual exchange or high receipt of support, while negative marital experiences are linked to patterns characterized by a downward transfer of support to children. Policymakers in developing settings should thus pay more attention to family dynamics when aiming to strengthen intergenerational support.
  5. Tung Ong L
    Hematol Oncol Stem Cell Ther, 2024 10 04;17(3):168-175.
    PMID: 39412752 DOI: 10.4103/hemoncstem.HEMONCSTEM-D-24-00009
    Fusarium infections have increased, particularly among patients with hematological malignancies and in those receiving hematopoietic stem cell transplantation (HSCT). This meta-summary summarizes the clinical characteristics, treatment, and outcomes of Fusarium infections in HSCT recipients. The PubMed, ScienceDirect, and Ovid SP databases were searched from inception to January 2024 to identify relevant case reports. A total of 31 patients diagnosed with Fusarium infections after HSCT were included. The most common infection sites were the skin and soft tissues (74.2%), blood (54.8%), and lungs (41.9%). Fusarium species complex was identified in 67.7% of the patients, and the most common species was Fusarium solani (51.6%). Of the included patients, 58.1% received antifungal monotherapy, whereas 41.9% received antifungal combination therapy. The overall mortality rate was 74.2%. Cutaneous infection was associated with a low mortality rate. The median time to mortality was 28 days. Fusarium infections commonly present as disseminated infections in HSCT recipients.
    MeSH terms: Antifungal Agents/therapeutic use; Humans
  6. Zhai X, Tong HHY, Lam CK, Xing A, Sha Y, Luo G, et al.
    Nat Hum Behav, 2024 Dec;8(12):2392-2405.
    PMID: 39496771 DOI: 10.1038/s41562-024-02033-0
    Depression represents a significant global public health challenge, and marital status has been recognized as a potential risk factor. However, previous investigations of this association have primarily focused on Western samples with substantial heterogeneity. Our study aimed to examine the association between marital status and depressive symptoms across countries with diverse cultural backgrounds using a large-scale, two-stage, cross-country analysis. We used nationally representative, de-identified individual-level data from seven countries, including the USA, the UK, Mexico, Ireland, Korea, China and Indonesia (106,556 cross-sectional and 20,865 longitudinal participants), representing approximately 541 million adults. The follow-up duration ranged from 4 to 18 years. Our analysis revealed that unmarried individuals had a higher risk of depressive symptoms than their married counterparts across all countries (pooled odds ratio, 1.86; 95% confidence interval (CI), 1.61-2.14). However, the magnitude of this risk was influenced by country, sex and education level, with greater risk in Western versus Eastern countries (β = 0.36; 95% CI, 0.16-0.56; P 
    MeSH terms: Adolescent; Adult; Aged; China/epidemiology; Cross-Sectional Studies; Cross-Cultural Comparison; Educational Status; Female; Great Britain/epidemiology; Humans; Indonesia/epidemiology; Ireland/epidemiology; Longitudinal Studies; Male; Mexico/epidemiology; Middle Aged; Risk Factors; Sex Factors; United States/epidemiology; Young Adult; Republic of Korea/epidemiology
  7. Richards-Rios P, Ashpole I, Chantrey J, Barbon AR
    J Zoo Wildl Med, 2024 Dec;55(4):936-948.
    PMID: 39699140 DOI: 10.1638/2024-0005
    Malaysian fire snails (Platymma tweediei), face threats to their environment, including habitat destruction and the illegal wildlife trade. Captive breeding projects are likely to play a role in the survival of this species; however, mortality in captive populations potentially presents a significant challenge. This paper presents the results of histopathologic examination of tissues from 10 P. tweediei casualties in a captive population at Chester Zoo. In October 2022, a captive breeding program was established with 20 wild-born P. tweediei. All adult founder animals died by July 2023, of which 10 were submitted for necropsy and histopathology of organs. Significant histologic abnormalities were present in all cases, primarily affecting the lung, integument, and heart. Histological analyses indicated a pneumonia-like condition was prevalent in all cases, suggesting potential environmental factors contributed to respiratory infections. A variety of possible etiologic or secondary infectious agents were present in sections including bacteria, fungi, and trematodes. There were some challenges in interpreting the histologic changes, emphasizing the need for more reference material and studies on the normal histologic anatomy of terrestrial gastropods. The findings underline the importance of understanding mortality events in captive populations to improve husbandry and environmental management. Additionally, the study recommends the submission of fresh specimens for necropsy to enhance diagnostic capabilities, such as bacterial culture, and suggests targeted sampling strategies for future research on captive snail species.
    MeSH terms: Animals; Animals, Zoo*; Female; Male
  8. Chaudhry G, Zeenia, Safdar N, Begum S, Akim AM, Sung YY, et al.
    Braz J Biol, 2024;84:e284409.
    PMID: 39699393 DOI: 10.1590/1519-6984.284409
    The importance of cytotoxicity assays in in vitro drug discovery investigations has led to their rising profile. Drugs and other substances can disrupt cell membranes, limit protein synthesis, and bind irreversibly to receptors, all of which lead to cell death in cancer cells. To precisely measure the cell death resulting from these damages, one must choose a cytotoxicity test that meets specific criteria. A systematic search strategy was used to gather grey literature from 2001 to 2024, utilizing databases such as PubMed and Google Scholar. Specific keywords related to colorimetric, fluorometric, and dye exclusion assays, as well as "cytotoxicity," were employed. Here, we only focus on screening drug cytotoxicity for cancer cells. This review discusses various cytotoxicity assays, such as "dye exclusion assays," "colorimetric assays," and "fluorometric assays." It is crucial to prioritize safety, speed, reliability, efficiency, and cost-effectiveness, while also ensuring minimal interference with the test compound. Commonly used in toxicology and pharmacology, cytotoxicity assays are based on several biological processes. Selecting the correct assay method requires considerations such as assay specificity and sensitivity, detection mechanism, test drug properties, and laboratory availability. This review aims to assist researchers in performing reliable cytotoxicity assessments by providing insights into assay choices.
    MeSH terms: Animals; Colorimetry/methods; Drug Screening Assays, Antitumor*; Fluorometry/methods; Humans; Neoplasms/drug therapy; Reproducibility of Results; Drug Discovery*
  9. Mat Ghani N, Hong KW, Liew YJM, Lau YY, Yong HS, Tee KK, et al.
    Pathog Glob Health, 2024 Dec 19.
    PMID: 39699991 DOI: 10.1080/20477724.2024.2442194
    Acinetobacter baumannii is a multidrug-resistant bacterium that has emerged as a significant nosocomial pathogen globally and renowned for its ability to acquire antimicrobial resistance (AMR) genes. However, understanding of its resistance mechanisms to certain drug classes remains limited. This study focused on four bacterial strains (AB863, AB889, AB930, and AB960) exhibiting carbapenem resistance. They demonstrated high minimum inhibitory concentration (MIC) (128 mg/L) to meropenem and were categorized as extensively drug-resistant strains. Subsequently, they were identified as A. baumannii through 16S rRNA gene sequence analysis and species-specific PCR targeting the blaOXA51-like gene. Three strains were sequenced for their genomes to study the genetic determinants and functional relevance of carbapenem resistance. The draft genome length of the strains ranged from 3.8 to 4.0 Mbp. A total of 16 antibiotic resistance genes including the genes blaOXA-23 and blaOXA-66 which mediate carbapenem resistance were identified in the genomes. A comprehensive multilocus sequence typing analysis involving 95 A. baumannii strains from different Asian countries assigned the four strains to sequence type 2 (ST2), the most predominant ST circulating in Asia. Comparative genome analysis also revealed blaOXA-66 as the most dominant variant of blaOXA-51-like gene and also a widespread distribution of blaOXA-23 gene. In addition, various mobile genetic elements associated with AMR genes and three efflux pumps families were detected in the genomes of the strains. Transformation of blaOXA-23 and blaOXA-66 genes resulted in meropenem resistance in the transformant which exhibited a MIC of 2 mg/L, thus confirming direct involvement of both genes in carbapenem resistance.
  10. Pitafi S, Anwar T, Widia IDM, Sharif Z, Yimwadsana B
    PLoS One, 2024;19(12):e0313890.
    PMID: 39700114 DOI: 10.1371/journal.pone.0313890
    Perimeter Intrusion Detection Systems (PIDS) are crucial for protecting any physical locations by detecting and responding to intrusions around its perimeter. Despite the availability of several PIDS, challenges remain in detection accuracy and precise activity classification. To address these challenges, a new machine learning model is developed. This model utilizes the pre-trained InceptionV3 for feature extraction on PID intrusion image dataset, followed by t-SNE for dimensionality reduction and subsequent clustering. When handling high-dimensional data, the existing Density-Based Spatial Clustering of Applications with Noise (DBSCAN) algorithm faces efficiency issues due to its complexity and varying densities. To overcome these limitations, this research enhances the traditional DBSCAN algorithm. In the enhanced DBSCAN, distances between minimal points are determined using an estimation for the epsilon values with the Manhattan distance formula. The effectiveness of the proposed model is evaluated by comparing it to state-of-the-art techniques found in the literature. The analysis reveals that the proposed model achieved a silhouette score of 0.86, while comparative techniques failed to produce similar results. This research contributes to societal security by improving location perimeter protection, and future researchers can utilize the developed model for human activity recognition from image datasets.
    MeSH terms: Machine Learning*; Algorithms*; Humans; Image Processing, Computer-Assisted/methods; Cluster Analysis
  11. Alshammari H, Al-Saeed E, Ahmed Z, Aslanpour Z
    PLoS One, 2024;19(12):e0311853.
    PMID: 39700210 DOI: 10.1371/journal.pone.0311853
    Deprescribing is defined as the reduction of medications to improve patient care. For effective deprescribing regular evaluation of medication adjustment regimens is required as it is documented to be an effective method to reduce polypharmacy and potentially inappropriate medications while improving patient well-being. Several factors, including patient-related aspects, influence the deprescribing process. Among these factors, patient willingness plays a pivotal role, making it essential to better understand their perspectives and attitudes towards medication use and deprescribing to successfully implement and maintain a deprescribing approach. We investigated the attitudes of older patients attending geriatric clinics in Kuwait toward deprescribing and identified predictors that influence their willingness to undergo this process. We enrolled patients aged ≥65 years who were attending geriatric clinics in primary care settings in Kuwait. These participants completed the revised Arabic version of the Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. The questionnaire was designed to assess the participants' willingness to participate actively in medication decision-making and their inclination toward discontinuing certain medicines. Descriptive statistics was applied to gain insight into the characteristics of the participants and their responses to the rPATD questionnaire. Binary logistic regression identified predictors influencing the desire to deprescribe among participants. The study included 535 participants, out of which 388 were analyzed, with 233 (43.6%) being women. The majority, 77% (n = 412), were aged between 65 and 74 years. Out of the total, 205 patients (38.4%) had one to two medical conditions and were prescribed between one and five medications. The participants showed a high willingness to deprescribe, and this willingness was inversely associated with sex (p = 0.15), age (p = 0.15), and polypharmacy (p = 0.044). Many older patients visiting geriatric clinics in primary care settings in Kuwait were receptive to the concept of deprescribing medications, particularly if advised by their doctor. Nevertheless, it was observed that male patients, individuals on more than 5 medications, and older age groups showed lower willingness to deprescribe.
    MeSH terms: Deprescriptions*; Aged; Aged, 80 and over; Female; Humans; Kuwait; Male; Surveys and Questionnaires; Polypharmacy*
  12. Hlayel M, Mahdin H, Hayajneh M, AlDaajeh SH, Yaacob SS, Rejab MM
    PLoS One, 2024;19(12):e0314691.
    PMID: 39700470 DOI: 10.1371/journal.pone.0314691
    The rapid development of Digital Twin (DT) technology has underlined challenges in resource-constrained mobile devices, especially in the application of extended realities (XR), which includes Augmented Reality (AR) and Virtual Reality (VR). These challenges lead to computational inefficiencies that negatively impact user experience when dealing with sizeable 3D model assets. This article applies multiple lossless compression algorithms to improve the efficiency of digital twin asset delivery in Unity's AssetBundle and Addressable asset management frameworks. In this study, an optimal model will be obtained that reduces both bundle size and time required in visualization, simultaneously reducing CPU and RAM usage on mobile devices. This study has assessed compression methods, such as LZ4, LZMA, Brotli, Fast LZ, and 7-Zip, among others, for their influence on AR performance. This study also creates mathematical models for predicting resource utilization, like RAM and CPU time, required by AR mobile applications. Experimental results show a detailed comparison among these compression algorithms, which can give insights and help choose the best method according to the compression ratio, decompression speed, and resource usage. It finally leads to more efficient implementations of AR digital twins on resource-constrained mobile platforms with greater flexibility in development and a better end-user experience. Our results show that LZ4 and Fast LZ perform best in speed and resource efficiency, especially with RAM caching. At the same time, 7-Zip/LZMA achieves the highest compression ratios at the cost of slower loading. Brotli emerged as a strong option for web-based AR/VR content, striking a balance between compression efficiency and decompression speed, outperforming Gzip in WebGL contexts. The Addressable Asset system with LZ4 offers the most efficient balance for real-time AR applications. This study will deliver practical guidance on optimal compression method selection to improve user experience and scalability for AR digital twin implementations.
    MeSH terms: Algorithms*; Humans; Models, Theoretical; Mobile Applications
  13. Wang R, Raman A
    Nurse Educ Pract, 2024 Dec 16;82:104238.
    PMID: 39700839 DOI: 10.1016/j.nepr.2024.104238
    AIM: The study aimed to comprehensively analyze and evaluate the effects of blended learning in nursing education.

    BACKGROUND: Blended learning addresses significant challenges in nursing education by offering flexible and adaptive learning environments that support the development of both theoretical knowledge and practical skills. Its importance grew post-COVID-19. Although some reviews have synthesized its effects in nursing education, they often focused on a limited scope and studies, leaving gaps in understanding its broader impact.

    DESIGN: Systematic literature review.

    METHODS: We employed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search for literature published in PubMed, CINAHL, Web of Science, EMBASE, ERIC, Scopus and Cochrane Library from 2000 to June 26, 2024. Two researchers independently screened each article for eligibility and extracted the data.

    RESULTS: This review included 54 studies and found that blended learning positively influenced nursing students in five key areas: academic performance and skill development, learning engagement and motivation, self-management in learning, psychological and emotional well-being, learning experience and satisfaction. These were captured in a visual model showing the comprehensive impact of blended learning. Critical research gaps were identified, including a lack of randomized controlled trials and limited studies on mental health and clinical thinking abilities.

    CONCLUSIONS: The results of the study showed that the effects of blended learning in nursing education were positive and multi-dimensional. Despite some inconsistencies in findings, blended learning was shown to offer significant advantages over traditional learning, though further research is required to address areas of uncertainty.

  14. Quar TK, Lim YF, Rashid MFN, Chu SY, Chong FY
    J Am Acad Audiol, 2024 Jul;35(7-08):204-213.
    PMID: 39701149 DOI: 10.1055/s-0044-1791214
    OBJECTIVE:  Many hearing aid manufacturers have developed application programs that allow audiologists to fine-tune or adjust their patients' hearing aids remotely. This study aims to explore audiologists' experiences in using the remote hearing aid adjustment in Malaysia.

    METHOD:  This is a qualitative research design where focus group discussions among audiologists were held. The interview data were analyzed using reflexive thematic analysis to identify patterns and reconstruct meaning.

    STUDY SAMPLE:  Ten audiologists with at least 1 year of work experience in providing remote hearing aid adjustment services to adult patients were recruited.

    RESULTS:  Even though there has been an increased utilization of remote fine-tuning among audiologists in Malaysia due to the coronavirus disease 2019 pandemic, its use among audiologists remains limited at present. Five thematic areas were identified: "Adoption of Practice," "Challenges and Limitations," "Benefits and Opportunities," "Satisfaction," and "Recommendations for Improvement." The TedAP challenges (T-technical challenges: e-ease of use, d-digital competency; A-abuse of system, and P-physical examinations) have been identified under the "Challenges and Limitations" theme. Suggestions for improvement include integrating the applications and video calls on a common platform, assigning a "standby" trained audiologist, and incorporating remote fine-tuning into audiology education.

    CONCLUSION:  Challenges and limitations associated with the provision of tele-audiology have been documented based on the views and experiences of audiologists in Malaysia. Despite the barriers, audiologists acknowledged the benefits associated with remote systems and recommendations were provided to improve the services. The results of this study could contribute to the increase in the use of tele-audiology in Malaysia. This would be instrumental in developing further the audiology profession in terms of the adoption of tele-audiology and telehealth in Malaysia.

    MeSH terms: Adult; Attitude of Health Personnel; Female; Hearing Aids*; Humans; Malaysia; Male; Correction of Hearing Impairment/methods; Focus Groups; Telemedicine*; Hearing Loss/rehabilitation; Hearing Loss/therapy; Qualitative Research*; Audiologists*
  15. Ye DN, Wang LY, Fei WT, Lin Q, Yan LY, Yang BR, et al.
    Zhongguo Zhong Yao Za Zhi, 2024 Sep;49(18):5095-5101.
    PMID: 39701690 DOI: 10.19540/j.cnki.cjcmm.20240611.401
    Tongkat Ali(Eurycoma longifolia Jack.) is a medicinal plant of Simaroubaceae in Southeast Asia, with centuries of medicinal history. Rich clinical and pharmacological research results have been attained for this plant, which demonstrates diverse and definite effects and high safety, showcasing advantages and broad market prospects to be introduced as a new medicinal plant. Currently, E. longifolia is cultivated in Hainan and Guangdong in China. However, it has not been utilized for the medicinal purpose in China, and the systematic study on its traditional Chinese medicine(TCM) properties remains to be carried out. This paper comprehensively reviews and analyzes the application history, clinical trials, biological activities, chemical composition, and safety of Tongkat Ali and probes into its TCM properties. The results suggest that Tongkat Ali is sweet, bitter, pungent, and plain, with tropism to the kidney, spleen, and liver meridians. Tongkat Ali has the main functions of tonifying kidney and replenishing essence, invigorating spleen and replenishing Qi, and soothing liver and relieving depression. The clinical applications of Tongkat Ali encompass kidney essence deficiency, sex apathy, spleen Qi deficiency, fatigue, liver depression and Qi stagnation. The recommended dosage and usage of this medicine are 2-10 g daily and decoction with water, respectively. This study aims to facilitate the compatible use and product development of Tongkat Ali while providing reference for introducing it as a new TCM resource and studying the TCM properties of ginseng plants abroad.
    MeSH terms: Animals; China; Panax/chemistry; Humans; Medicine, Chinese Traditional
  16. Pansiritanachot W, Riyapan S, Shin SD, Chantanakomes J, Thirawattanasoot N, Rangabpai W, et al.
    Int J Emerg Med, 2024 Dec 20;17(1):193.
    PMID: 39701949 DOI: 10.1186/s12245-024-00787-y
    BACKGROUND: Evidence regarding the effect of time to neurosurgical and neuroradiological intervention on outcomes in traumatic brain injury (TBI) across Asia-Pacific region is limited. This study evaluates the quality of care and outcomes for TBI patients undergoing neurosurgical and neuroradiological procedures at different timings.

    METHODS: Adult TBI patients who received any neurosurgical or neuroradiological interventions during the year 2015-2022 in the Pan-Asian Trauma Outcome Study database were analyzed. The time to intervention, as the main exposure, was classified into three groups (Early, Intermediate, and Delayed) using Restricted Cubic Spline (RCS) analysis. The outcomes were in-hospital mortality and unfavorable neurological outcomes. W score was utilized to compare the quality of care among exposure groups. Multivariable logistic regression analysis and interaction analysis were performed to identify the association between the exposure groups and outcomes, reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).

    RESULTS: A total of 1,780 patients were included. From the RCS analysis, patients were classified into three groups according to time to intervention: Early ( 4.1 h). According to the time to intervention, W score was - 8.6 in the early group, -1.1 in the intermediate group, and + 0.4 in the delayed group. Patients receiving intermediate and delayed intervention showed significantly lower mortality (AOR 0.64, 95% CI 0.47-0.86 and AOR 0.66, 95%CI 0.48-0.90, respectively).

    CONCLUSION: Early neurosurgical and neuroradiological interventions in TBI patients in the Asia-Pacific region were associated with lower quality of care and higher mortality. The quality of care should be focused and improved during the early hours of TBI.

  17. Supramaniam P, Beh YS, Junus S, Devesahayam PR
    BMC Public Health, 2024 Dec 19;24(1):3542.
    PMID: 39702047 DOI: 10.1186/s12889-024-21056-w
    BACKGROUND: Mobile health applications (mHealth apps) offer potential benefits for improving diabetes management, such as better glucose monitoring and patient engagement, but their widespread adoption faces challenges, including privacy concerns and user adherence. This research investigates mHealth app usage among patients living with diabetes in Kinta District, Perak, exploring experiences, challenges and patient perceptions regarding diabetes management using mHealth apps.

    METHODOLOGY: A cross-sectional community survey was conducted in September till November 2020 across nine government health clinics focusing on diabetes mellitus (Type 1 or Type 2) patients, aged 18 years and older, receiving Diabetes Medication Adherence Counseling (DMTAC) services and able to use smart devices. A self-developed questionnaire with four sections was used to gather demographic information, explore mHealth apps usage and understand both users and non-users' experiences and perceptions. The questionnaire was tested through cognitive debriefing, translated into Malay, pre-tested and finalized by the expert committee. The questionnaire was digitally implemented using Google® Form and QR code. After obtaining informed consent, data collection was performed by the trained DMTAC pharmacists. Statistical analyses involved descriptive and inferential analyses.

    RESULTS: The study analyzed the engagement of 295 patients living with diabetes with mHealth apps. Females (54.9%), of Malay ethnicity (58.3%) and with a mean age of 53.8 years (SD: 12.38) constituted the majority. Diabetes duration had a median of 6 years (IQR: 3.0, 10.0) with prevalent comorbidities like hypertension (58.0%) and dyslipidemia (42.7%). Most patients were employed (44.7%) and their primary source of diabetes management information was through healthcare providers (92.5%). Despite the high app use for social interaction, only 13.6% used mHealth apps for disease management. Users were influenced by social media (65.0%) and favored for wellness apps and disease monitoring. Users perceived the mHealth app as useful (97.5%), yet faced challenges over the app initiation, charges and data security. Non-users cited lack of awareness (70.2%), struggled with app startup (22.4%) and preference for conventional healthcare visits (22.0%). In multivariable analysis, longer diabetes duration reduced mHealth app usage (p = 0.046), while multimorbidity increased the likelihood (p = 0.001). Awareness of the availability of health apps significantly influenced the usage of mHealth apps (p 

    MeSH terms: Adult; Aged; Cross-Sectional Studies; Diabetes Mellitus/therapy; Diabetes Mellitus, Type 2/psychology; Diabetes Mellitus, Type 2/therapy; Female; Humans; Malaysia; Male; Middle Aged; Surveys and Questionnaires; Telemedicine*; Young Adult
  18. Leyva-Grado VH, Promeneur D, Agans KN, Lazaro GG, Borisevich V, Deer DJ, et al.
    NPJ Vaccines, 2024 Dec 19;9(1):244.
    PMID: 39702562 DOI: 10.1038/s41541-024-01036-2
    The limited but recurrent outbreaks of the zoonotic Nipah virus (NiV) infection in humans, its high fatality rate, and the potential virus transmission from human to human make NiV a concerning threat with pandemic potential. There are no licensed vaccines to prevent infection and disease. A recombinant Hendra virus soluble G glycoprotein vaccine (HeV-sG-V) candidate was recently tested in a Phase I clinical trial. Because NiV outbreaks are sporadic, and with a few cases, licensing will likely require an alternate regulatory licensing pathway. Therefore, determining a reliable vaccine correlate of protection (CoP) will be critical. We assessed the immune responses elicited by HeV-sG-V in African Green monkeys and its relationship with protection from a NiV challenge. Data revealed values of specific binding and neutralizing antibody titers that predicted survival and allowed us to establish a mechanistic CoP for NiV Bangladesh and Malaysia strains.
  19. Govindasamy N, Barman M, Salleh N, Giribabu N, Shahzad H
    PMID: 39702602 DOI: 10.1007/s00210-024-03700-9
    Rheumatoid arthritis (RA) can cause blood pressure (BP) elevation in estrogen-deficient, post-menopausal women; however, the underlying mechanisms are not well understood. In this study, the aortic involvement and its underlying mechanisms that contribute to the BP elevation in estrogen-deficient, RA condition were identified. Ovariectomy was performed to create a state of estrogen deficiency and RA was then induced in ovariectomized rats by using incomplete Freund's adjuvant and immune-mediated collagen type-II. Ovariectomized, RA-induced rats (Ovx + RA) were given either 17β-estradiol, baricitinib, or losartan. Direct blood pressure (BP) monitoring was made via cannulation of the carotid artery. Rats were then sacrificed and the aorta was harvested followed by H&E and Picrosirius staining to evaluate histological changes and collagen deposition. Oxidative stress, inflammation, apoptosis, growth, and fibrosis levels in the aorta were assessed by using molecular biological techniques. Mean arterial pressure (MAP) was significantly elevated in Ovx + RA rats when compared to sham and Ovx rats (p 
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