Browse publications by year: 2024

  1. Tan YF, Hii LW, Lim WM, Cheong SK, Leong CO, Yee MS, et al.
    Sci Rep, 2024 Dec 03;14(1):30098.
    PMID: 39627280 DOI: 10.1038/s41598-024-80646-1
    Small interfering RNAs (siRNA) technology has emerged as a promising therapeutic tool for human health conditions like cancer due to its ability to regulate gene silencing. Despite FDA-approved, their delivery remains localized and limiting their systemic use. This study used single-walled carbon nanotubes (SWNTs) functionalized with polyethylene glycolated (PEGylated) phospholipids (PL-PEG) derivatives for systemic siRNA delivery. We developed an siRNA systemic delivery vehicle (SWNT-siRNA) by conjugating SWNT functionalized with PL-PEG containing either amine (PA) or maleimide (MA). The functionalized SWNT with a lower molecular weight of PA produced the SWNT-siRNA conjugate system with the highest stability and high siRNA loading quantity. The system delivered siRNA to a panel of tumour cell lines of different organs (i.e. HeLa, H1299 and MCF-7) and a non-cancerous human embryonic kidney 293 cells (HEK293T) with high biocompatibility and low toxicity. The cellular uptake of SWNT-siRNA conjugates by epithelial cells was found to be energy dependent. Importantly, the presence of P-glycoprotein, a marker for drug resistance, did not inhibit SWNT-mediated siRNA delivery. Mouse xenograft model further confirmed the potential of SWNT-siRNA conjugates with a significant gene knock-down without signs of acute toxicity. These findings pave the way for potential gene therapy applications using SWNTs as delivery vehicles.
    MeSH terms: Animals; HeLa Cells; Humans; Gene Transfer Techniques; Gene Silencing; Xenograft Model Antitumor Assays; Cell Line, Tumor; Mice; HEK293 Cells; MCF-7 Cells
  2. Hossain MK, Islam MA, Uddin MS, Paramasivam P, Hamid JA, Alshgari RA, et al.
    Sci Rep, 2024 Dec 03;14(1):30142.
    PMID: 39627336 DOI: 10.1038/s41598-024-81797-x
    In this work, CsPb.625Zn.375IBr2-based perovskite solar cells (PSCs) are numerically simulated and optimized under ideal lighting conditions using the SCAPS-1D simulator. We investigate how various hole transport layers (HTL) including Zn3P2, PTAA, MoS2, MoO3, MEH-PPV, GaAs, CuAlO2, Cu2Te, ZnTe, MoTe2, CMTS, CNTS, CZTS, CZTSe and electron transport layers (ETL) such as CdS, SnS2, ZnSe, PC60BM interact with the devices' functionality. Following HTL material optimization, a maximum power conversion efficiency (PCE) of 16.59% was observed for the FTO/SnS2/CsPb.625Zn.375IBr2/MoS2/Au structure, with MoS2 proving to be a more economical option. The remainder of the investigation is done following the HTL optimization. We study how the performance of the PSC is affected by varying the materials of the ETL and to improve the PCE of the device, we finally optimized the thickness, charge carrier densities, and defect densities of the absorber, ETL, and HTL. In the end, the optimized arrangement produced a VOC of 0.583 V, a JSC of 43.95 mA/cm2, an FF of 82.17%, and a PCE of 21.05% for the FTO/ZnSe/CsPb.625Zn.375IBr2/MoS2/Au structure. We also examine the effects of temperature, shunt resistance, series resistance, generation rate, recombination rate, current-voltage (JV) curve, and quantum efficiency (QE) properties to learn more about the performance of the optimized device. At 300 K, the optimized device provides the highest thermal stability. Our research shows the promise of CsPb.625Zn.375IBr2-based PSCs and offers insightful information for further development and improvement.
  3. Shukhairi SS, Mazlan N, Subbiah VK, Abd Rahman NN, Nazahuddin MNA, Shawel AS, et al.
    Bull Environ Contam Toxicol, 2024 Dec 03;114(1):2.
    PMID: 39627569 DOI: 10.1007/s00128-024-03980-0
    Microplastics (MPs) are tiny plastic pieces having a diameter of less than 5 mm. They can arise from larger plastic debris that degrades over time, synthetic fibres from clothing, microbeads in personal care items and even larger plastic debris. Sea cucumbers are marine creatures vital to the ocean's ecosystem as they assist in maintaining a clean seabed and recycle nutrients. The aim of this research was to characterize the types of MPs isolated from the sea cucumber Holothuria scabra from Pulau Jambongan, Sabah. A total of 30 H. scabra were collected. Their gastrointestinal tracts were removed and digested using NaOH. The digestates were filtrated several times to extract the MPs. MPs were observed under microscope and categorized into shapes and colours. To determine the functional group of polymers, further analysis using Fourier Transform-Infrared Spectroscopy (FTIR) was performed. The samples contained a total of 7403 MPs. Majority of MPs were black colored (72.25%) and in the form of fibres (99.05%). Two types of polymers were detected: polycarbonate (PC) found in 4% of the population and polymethyl methacrylate (PMMA) present in 96%. In conclusion, the presence of MPs in the gastrointestinal tract of H. scabra suggests that the animals and their habitat have been contaminated. Further study is required to comprehend the effects of MPs on sea cucumbers and other marine organisms as well as to develop prevention strategies.
    MeSH terms: Animals; Environmental Monitoring*; Malaysia
  4. Torimitsu S, Nakazawa A, Flavel A, Iwase H, Makino Y, Hisham S, et al.
    Int J Legal Med, 2024 Dec 04.
    PMID: 39627577 DOI: 10.1007/s00414-024-03386-x
    It is imperative in a forensic investigation to determine the identity of an unidentified corpse, for which a crucial starting point is to establish population affinity as part of the biological profile supplied by the forensic anthropologist. The present study investigates the feasibility of using multidetector computed tomography (MDCT) images to quantify craniometric variation between Japanese and Malay populations relative to the estimation of population affinity in a forensic context. The Japanese and Malay samples comprise MDCT scans of 252 (122 female; 130 male) and 182 (84 female; 98 male) adult individuals, respectively. A total of 18 measurements were acquired, and two machine learning methods (random forest modeling, RFM; support vector machine, SVM) were applied to classify population affinity. The accuracy of the two-way pooled-sex model was 88.0% for RFM and 94.5% for SVM, respectively. The four-way population and sex model produced an overall classification accuracy of 81.3% for RFM and 91.7% for SVM. The sex-specific models of population affinity showed correct rates of classification of more than 90% in both females (90.8% for RFM and 97.6% for SVM) and males (91.2% for RFM and 97.4% for SVM). Our findings clearly indicate that the cranial measurements acquired in MDCT images can be used for the forensic classification of Japanese and Malay individuals and thus serve as a reference for forensic anthropologists attempting to identify unidentified remains.
  5. Salikin NH, Keong LC, Azemin WA, Philip N, Yusuf N, Daud SA, et al.
    World J Microbiol Biotechnol, 2024 Dec 04;40(12):402.
    PMID: 39627623 DOI: 10.1007/s11274-024-04190-w
    Multidrug-resistant (MDR) Staphylococcus aureus represents a major global health issue resulting in a wide range of debilitating infections and fatalities. The slow progression of new antibiotics, limited choices for treatment, and scarcity of new drug approvals create immense obstacles in new drug line development. S. aureus poses a significant public health risk, due to the emergence of methicillin-resistant (MRSA) and vancomycin-resistant strains (VRSA), necessitating novel antibiotics for effective control management. Current studies are delving into the terpenes' potential as an antimicrobial agent, indicating positive prospects as promising substitutes or complementary to conventional antibiotics. Concurrent reactions of terpenes with conventional antibiotics create synergistic effects that significantly enhance antibiotic efficacy. Accumulated evidence has shown that while efflux pump (e.g., NorA, TetK, and MepA) is revealed as an essential defense of S. aureus against antibiotics, terpene and its derivative act as its potent inhibitor, suggesting the promising potential of terpenes in combating those infectious pathogens. Furthermore, pronounced cell membrane disruptive activity and antibiofilm properties by terpenes have been exerted, signifying their significance as promising prevention against microbial pathogenesis and antimicrobial resistance. This review provides an overview of the potential of terpenes and their derivatives in combating S. aureus infections, highlighting their potential mechanisms of action (MOA), synergistic effects with conventional antibiotics, and challenges in clinical translation. The unique properties of terpenes offer an opportunity for their use in developing an exceptional defense strategy against antibiotic-resistant S. aureus.
    MeSH terms: Animals; Drug Synergism; Humans; Microbial Sensitivity Tests
  6. Baharum H, Ismail A, Awang Z, McKenna L, Ibrahim R, Mohamed Z, et al.
    BMC Nurs, 2024 Dec 03;23(1):879.
    PMID: 39627761 DOI: 10.1186/s12912-024-02543-2
    BACKGROUND: Graduate nurses commonly experience the transition phase and are required to adapt quickly to their new workplace, as it is a prerequisite for a successful transition. However, workplace adaptation is extremely challenging and may affect nurses' future career prospects if not managed properly. Therefore, we aimed to determine the factors that facilitate newly employed nurses' adaptation and integration at Ministry of Health (MOH)-run state hospitals in Malaysia. The study framework was derived and adapted from the Roy adaptation model and organisational socialisation theories.

    METHODS: This quantitative study was conducted from May 2021 to December 2021. The sample population was newly employed nurses working at state hospitals with 1-2 years of service experience. This study involved 496 newly hired nurses from MOH state hospitals. Questionnaires were distributed through Google Forms. The data were analysed using covariance-based structural equation modelling.

    RESULTS: The participants perceived that workplace organisation (OC), academic institution contribution (AIC), and new nurse's personality traits (PT) contributed approximately 36% to newly employed nurses' adaptation (NENA). PT partially mediated the relationship between OC and NENA and between AIC and NENA.

    CONCLUSIONS: The results could be useful to nursing authorities. We also recommend that a nurse's personality be developed, emphasised, and enhanced through continuous programmes or training to ensure that they can easily adapt to their new working environment. Furthermore, academic institution and work organisation collaboration should be encouraged to develop improvement cycles that facilitate newly employed nurses' prompt and efficient adaptation at MOH hospitals during transition.

  7. Li Y, Meng L, Gong L, Wang X, Yang X, Li T
    BMC Ophthalmol, 2024 Dec 03;24(1):521.
    PMID: 39627768 DOI: 10.1186/s12886-024-03785-z
    OBJECTIVE: To explore the clinical efficacy of modified limbal stem cell transplantation(Modified LSC transplantation) and bandage contact lens(BCL) implantation in pterygium surgery.

    METHODS: A total of 479 patients with primary pterygium who were admitted to our hospital from March 2019 to March 2023 were randomly divided into three groups: the normal group (Group A: 89 patients), the control group (Group B: 195 patients), and the modified group (Group C: 195 patients). Each group received different intervention measures. Group A did not undergo surgical treatment and were required to follow up as outpatients. Group B received LSC transplantation combined with interrupted suturing plus BCL, whereas Group C received modified LSC transplantation combined with BCL. The degree of corneal irritation symptoms, wound healing and graft status under slit lamp, incidence and recurrence rate of complications, tear film rupture time, tear secretion test, intraocular pressure, ocular surface inflammation response(IL-1β, PGE2, TNF-α, VEGF), and visual quality were compared and analyzed at various time points after surgery.

    RESULTS: Compared with those in the Group B, patients in the Group C experienced faster normalization of corneal epithelium recovery, fewer corneal irritation symptoms, and better wound healing. The break-up time (BUT) of the tear film at 1 week to 1 year postoperatively was significantly greater in the Group C than Group B, with values approaching those of Group A by 3 months (P  0.05). The ELISA results indicated that the expression levels of the ocular surface inflammatory factors IL-1β, TNF-α, PEG2, and VEGF in the Group C were lower than those in Group B from 1 week to 1 year post surgery. Under both natural light and low-light conditions (spatial frequency/6 cd), Group C had better best-corrected visual acuity and contrast sensitivity than Group B at 1 week to 1 year postoperatively. Additionally, Group C had lower corneal higher-order aberrations (including astigmatism, spherical aberrations, and total higher-order aberrations) and superior vision-related quality of life scores at 1 year postoperatively than Group B, with statistically significant differences (P 

    MeSH terms: Adult; Aged; Female; Follow-Up Studies; Humans; Intraocular Pressure/physiology; Male; Middle Aged; Wound Healing; Limbus Corneae*; Treatment Outcome; Stem Cell Transplantation/methods
  8. Supian NS, Ibrahim MI
    BMC Nurs, 2024 Dec 03;23(1):882.
    PMID: 39627828 DOI: 10.1186/s12912-024-02557-w
    BACKGROUND: Poor sleep quality among nurses can negatively impact their performance, leading to increased risks of errors in nursing practice, which directly affect patient safety. However, there is limited research on the factors influencing sleep quality and its subsequent consequences on patient safety, particularly in tertiary hospitals in Kelantan, Malaysia. This study aimed to determine the factors influencing sleep quality and the prevalence of poor sleep quality among nurses at tertiary hospitals in Kelantan.

    METHODOLOGY: A cross-sectional study was conducted in two tertiary care hospitals in Kelantan between December 2023 and February 2024. A proportionate stratified random sampling method was employed to recruit a sample of 470 registered nurses. Data were collected using a validated self-administered questionnaire comprising 19 items across seven component scores.

    RESULTS: The prevalence of poor sleep quality among nurses was found to be 69.8%. The study identified several significant factors associated with poor sleep quality, including sleep duration (aOR 0.291; 95% CI: 0.215-0.393; p 

  9. Huang Z, Iqbal Z, Zhao Z, Liu J, Alabsi AM, Shabbir M, et al.
    J Transl Med, 2024 Dec 03;22(1):1096.
    PMID: 39627858 DOI: 10.1186/s12967-024-05900-6
    The bone marrow niche is a special microenvironment that comprises elements, including hematopoietic stem cells, osteoblasts, and endothelial cells, and helps maintain their characteristic functions. Here, we elaborate on the crosstalk between various cellular components, hematopoietic stem cells, and other cells in the bone marrow niche. We further explain the mechanism of preserving equilibrium in the bone marrow niche, which is crucial for the directional regulation of bone reconstruction and repair. Additionally, we elucidate the intercommunication among osteocytes, the regulation of osteoblast maturation and activation by lymphocytes, the deficiency of megakaryocytes that can markedly impair osteoblast formation, and the mechanism of interaction between macrophages and mesenchymal stem cells in the bone marrow niche. Finally, we discussed the new immunotherapies for bone tumors in the BM niche. In this review, we aimed to provide a candid overview of the crosstalk among bone marrow niche cells and to highlight new concepts underlying the unknown mechanisms of hematopoiesis and bone reconstruction. Thus, this review may provide a more comprehensive understanding of the role of these niche cells in improving hematopoietic function and help identify their therapeutic potential for different diseases in the future.
    MeSH terms: Animals; Bone Marrow*; Cell Communication*; Hematopoietic Stem Cells/cytology; Humans; Osteoblasts/cytology; Stem Cell Niche*
  10. Wong WK, Abu Bakar Sajak A, Chua HS
    Arthroplasty, 2024 Dec 04;6(1):60.
    PMID: 39627902 DOI: 10.1186/s42836-024-00281-z
    BACKGROUND: Only 80% of patients are satisfied with their outcomes post-TKA. Mounting attention has been paid to constitutional limb alignment and individualized alignment strategies in recent years. MacDessi et al. proposed the CPAK classification, which takes into account the patients' arithmetic hip-knee-ankle axis (aHKA) and joint line obliquity (JLO). In this study, we aimed to establish local demographic data, compare them with published data, and assess their correlations with modifiable variables.

    METHODS: A total of 500 end-stage osteoarthritic knees subjected to TKA were radiologically analyzed. The lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were calculated from long limb radiographs before the aHKA and JLO were derived and a CPAK phenotype was assigned. Demographic data were harvested and analyzed for possible correlations.

    RESULTS: There were 160 males (32%) and 340 females (68%), with a mean age of 66.42 years (range, 47-88). The mean MPTA was 85.8° (± 3.0)°, and the mean LDFA was 87.6° (± 2.4)°. The average aHKA was a varus of 1.8° (± 4.2)°, and the average JLO was 173.4° (± 3.45)°. The most common CPAK phenotype was Type 1 (43.4%). The Intraclass Correlation Coefficient demonstrated excellent reliability (> 0.9). No correlation existed between CPAK phenotypes and age, height, weight, or body mass index (BMI), but CPAK phenotype was significantly correlated with gender.

    CONCLUSION: An urban Malaysian population with osteoarthritic knees was found to be constitutionally varus, with the most common phenotype being varus aHKA with an apex-distal JLO. Constitutional alignment is not influenced by factors such as age, height, weight, or BMI.

    LEVEL OF EVIDENCE: Retrospective Observational Study-III.

  11. Pandurangan V, Sarojam SP, Narayanan P, Velayutham M
    Network, 2024 Dec 03.
    PMID: 39628058 DOI: 10.1080/0954898X.2024.2428705
    Skin melanin lesions are typically identified as tiny patches on the skin, which are impacted by melanocyte cell overgrowth. The number of people with skin cancer is increasing worldwide. Accurate and timely skin cancer identification is critical to reduce the mortality rates. An incorrect diagnosis can be fatal to the patient. To tackle these issues, this article proposes the Recurrent Prototypical Object Segmentation Network (RPO-SegNet) for the segmentation of skin lesions and a hybrid Deep Learning (DL) - based skin cancer classification. The RPO-SegNet is formed by integrating the Recurrent Prototypical Networks (RP-Net), and Object Segmentation Networks (O-SegNet). At first, the input image is taken from a database and forwarded to image pre-processing. Then, the segmentation of skin lesions is accomplished using the proposed RPO-SegNet. After the segmentation, feature extraction is accomplished. Finally, skin cancer classification and detection are accomplished by employing the Fuzzy-based Shepard Convolutional Maxout Network (FSCMN) by combining the Deep Maxout Network (DMN), and Shepard Convolutional Neural Network (ShCNN). The established RPO-SegNet+FSCMN attained improved accuracy, True Negative Rate (TNR), True Positive Rate (TPR), dice coefficient, Jaccard coefficient, and segmentation analysis of 91.985%, 92.735%, 93.485%, 90.902%, 90.164%, and 91.734%.
  12. Wahyuningsih S, Widati S, Praveena SM, Azkiya MW
    Front Reprod Health, 2024;6:1444111.
    PMID: 39628795 DOI: 10.3389/frph.2024.1444111
    INTRODUCTION: Sexual and reproductive health (SRH) among adolescents is a critical aspect of global health. Rural adolescents often encounter significant barriers to reproductive health awareness, elevating their risks for unintended pregnancies, sexually transmitted infections (STIs), and other reproductive health issues. This systematic review seeks to identify and analyze the barriers hindering reproductive health awareness among rural adolescents.

    METHODS: This review followed PRISMA guidelines. Literature searches were conducted in PubMed, ScienceDirect, Google Scholar, and Taylor & Francis, focusing on studies published from 2019 to 2024. Keywords included "Adolescent," "Rural," "Reproductive Health," "Awareness," and "Barriers." Studies were screened based on eligibility criteria, and data were extracted and analyzed to identify key barriers at the individual, interpersonal, social/community, and health services levels.

    RESULTS: Out of 669 records, 20 studies met the inclusion criteria. Identified barriers at the individual level included lack of knowledge, myths, misconceptions, and feelings of shame and fear. Interpersonal barriers were related to poor communication between parents and adolescents and misinformation from peers. Social and community barriers encompassed rigid social norms, stigma, and discrimination. Health services barriers included limited access and negative experiences with reproductive health services.

    DISCUSSION: Rural adolescents face complex barriers to reproductive health awareness driven by factors at the individual, interpersonal, social, and health services levels. Comprehensive interventions, such as educational campaigns, training for healthcare providers, and improved access via mobile or online platforms, are essential to enhance reproductive health awareness and outcomes.

    SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/, PROSPERO (CRD42024554439).

  13. Mahesh S, van der Werf E, Mallappa M, Vithoulkas G, Lai NM
    J Med Life, 2024 Sep;17(9):830-839.
    PMID: 39628966 DOI: 10.25122/jml-2024-0081
    It is unclear whether fever suppression in the elderly provides long-term benefits or poses risks due to their distinct immune profiles and body temperature regulation compared to younger individuals. This study aimed to assess the long-term health effects of antipyretic treatment during infections in the elderly. A systematic review was conducted, including studies that compared antipyretic treatment with other drugs, therapies, placebo, or no treatment. PubMed, Embase and Cochrane CENTRAL databases were searched. Primary and secondary outcomes were the onset or worsening of chronic inflammatory diseases, fever reduction, length of hospital stay, patient satisfaction, mortality, laboratory indicators of morbidity, and progression to complications, respectively. Out of 11,481 studies screened, 17 were included (two randomized controlled trials [RCTs], seven observational studies, one case series, and seven case reports). None investigated the primary outcome or patient-reported outcomes. The risk of bias in the included studies ranged from unclear to high. Due to the heterogeneity of the studies, a narrative synthesis was conducted, as meta-analysis was not feasible. Antipyretics showed a significant reduction of fever in RCTs. Five studies reported a significant drop in blood pressure, and one showed significant mortality from antipyretics. Morbidity indicators and length of stay were available only in the studies that reported adverse events. The certainty of evidence, assessed using GRADE, was low to very low for all outcomes. Evidence regarding the long-term benefit or harm from fever suppression with antipyretics during infections in the elderly is insufficient.
    MeSH terms: Aged; Aged, 80 and over; Aging; Humans
  14. Koh HP, Lai SN, Chong WW, Mohd Pauzi Z
    J Asthma, 2024 Dec 09.
    PMID: 39629659 DOI: 10.1080/02770903.2024.2438094
    BACKGROUND: The Global Initiative for Asthma (GINA) has suggested the need for more studies on inhaled corticosteroid (ICS)-formoterol in the Emergency Department (ED).

    OBJECTIVES: We aimed to compare the outcomes of budesonide/formoterol (160/4.5 mcg/inhalation) turbuhaler versus pressurized metered-dose inhaler (pMDI) salbutamol (100 mcg/puff) in acute asthma in the outpatient ED.

    METHODS: This single-centre, prospective, randomized, and open-label study involved adult asthma patients with mild to moderate asthma exacerbation who attended the outpatient ED of a tertiary hospital in Malaysia. The intervention arm received budesonide/formoterol (Symbicort® 160/4.5 mcg) turbuhaler, while the control arm received pMDI salbutamol with a valved holding chamber. Stratified randomization with variable baseline ICS use was employed. Direct discharge rate from outpatient ED was the primary outcome. Vital signs pre- and post-treatment between the two arms were also compared.

    RESULTS: Seventy-four (n = 37 for each arm) asthma patients were recruited. Baseline clinical characteristics were comparable between the two arms. Direct discharge rates from ED were comparable between the intervention (94.6%) and the control (91.9%) arms (p = 1.000). Post-treatment outcomes (respiratory rate, oxygen saturation, peak expiratory flow rate) were similar between the two arms, except for the higher increment of heart rate (p 

  15. Mudgil P, Gan CY, Yap PG, Redha AA, Alsaadi RHS, Mohteshamuddin K, et al.
    J Dairy Sci, 2024 Dec;107(12):10153-10173.
    PMID: 39122154 DOI: 10.3168/jds.2024-25108
    Bioactive peptides produced via enzymatic hydrolysis have been widely investigated for their dipeptidyl peptidase-IV (DPP-IV) inhibitory properties. However, the deficit of studies on fermentation as a means to produce DPP-IV inhibitory peptides prompted us to draw a comparative study on DPP-IV inhibitory peptides generated from cow, camel, goat, and sheep milk using probiotic fermentation. Further, peptide identification, in silico molecular interactions with DPP-IV, and ensemble docking were performed. Results suggested that goat milk consistently exhibited greater degrees of hydrolysis than other milk types. Further, Pediococcus pentosaceus (PP-957) emerged as a potent probiotic, with significantly lower median inhibitory concentration values of DPP-IV, of 0.17, 0.12, and 0.25 µg/mL protein equivalents in fermented cow, camel, and goat milk, respectively. Overall, peptides (RPPPPVAM, CHNLDELKDTR, and VLSLSQPK) exhibited strong binding affinity, with binding energies of -9.31, -9.18, and -8.9 kcal/mol, respectively, suggesting their potential role as DPP-IV inhibitors. Overall, this study offers valuable information toward antidiabetic benefits of fermented milk products via inhibition of DPP-IV.
    MeSH terms: Animals; Cattle; Fermentation*; Goats; Peptides*; Probiotics*
  16. Alyafeai E, Qaed E, Al-Mashriqi HS, Almaamari A, Almansory AH, Futini FA, et al.
    Mutat Res, 2024;829:111883.
    PMID: 39265237 DOI: 10.1016/j.mrfmmm.2024.111883
    The integrity of the genetic material in human cells is continuously challenged by environmental agents and endogenous stresses. Among these, environmental carcinogens are pivotal in initiating complex DNA lesions that can lead to malignant transformations if not properly repaired. This review synthesizes current knowledge on the molecular dynamics of DNA repair mechanisms and their interplay with various environmental carcinogens, providing a comprehensive overview of how these interactions contribute to cancer initiation and progression. We examine key DNA repair pathways including base excision repair, nucleotide excision repair, and double-strand break repair and their regulatory networks, highlighting how defects in these pathways can exacerbate carcinogen-induced damage. Further, we discuss how understanding these molecular interactions offers novel insights into potential therapeutic strategies. This includes leveraging synthetic lethality concepts and designing targeted therapies that exploit specific DNA repair vulnerabilities in cancer cells. By integrating recent advances in molecular biology, genetics, and oncology, this review aims to illuminate the complex landscape of DNA repair and carcinogen-induced carcinogenesis, setting the stage for future research and therapeutic innovations.
    MeSH terms: Animals; DNA Damage; DNA Repair*; Humans; Disease Progression; DNA Breaks, Double-Stranded; Molecular Dynamics Simulation; Carcinogenesis/chemically induced; Carcinogenesis/genetics
  17. Soon B, Jaafar AS, A Bakar A, Narayanan V
    World Neurosurg, 2024 Nov;191:e607-e621.
    PMID: 39265943 DOI: 10.1016/j.wneu.2024.09.012
    OBJECTIVE: This study aimed to assess the diagnostic accuracy of a novel marker, the combined lactate glucose ratio (CLGR), in identifying cerebrospinal fluid (CSF) bacterial infection (CBI) in neurosurgical patients. Additionally, it seeks to establish cutoff values for CLGR and evaluate the reliability of measurement using blood gas analyzer (BGA).

    METHODS: CSF samples were collected from 2 neurosurgical centers in Kuala Lumpur, Malaysia, between January 2022 and October 2023. Conventional markers and CLGR were quantified using standard laboratory methods, with BGA utilized for measurement when feasible. Samples were categorized into confirmed CBI-positive (CBI+) and CBI-negative (CBI-) groups. Marker performance was compared, and receiver operating characteristic analysis conducted. Pearson correlation assessed the agreement between BGA and laboratory measurements.

    RESULTS: Among the 130 CSF samples, 11 were CBI+. Both cerebrospinal fluid lactate (cLac) and CLGR were significantly elevated in the CBI + group (P < 0.001). The area under the curve for cLac and CLGR was 0.990 and 0.994, respectively. Using a cutoff of 6.0 mmol/L, cLac demonstrated sensitivity of 100%, specificity of 93.3%, positive predictive value of 57.9%, negative predictive value of 100%, and diagnostic accuracy of 93.9%. CLGR ≥20.0 showed even higher accuracy: 100.0% sensitivity, 98.6% specificity, 84.6% positive predictive value, 100% negative predictive value, and overall accuracy of 98.5%. Both markers maintained excellent performance in blood-stained CSF. BGA measurements correlated well with laboratory results (r = 0.980 and 0.999, respectively, P < 0.001).

    CONCLUSIONS: CLac levels ≥6.0 mmol/L and CLGR ≥20.0 accurately identified CBI in neurosurgical patients, with CLGR exhibiting superior efficacy. The potential for instant BGA measurement suggests promise for point-of-care testing.

    MeSH terms: Adult; Aged; Blood Gas Analysis/methods; Female; Humans; Male; Middle Aged; Sensitivity and Specificity; Reproducibility of Results; Neurosurgical Procedures*; Central Nervous System Bacterial Infections/cerebrospinal fluid; Central Nervous System Bacterial Infections/diagnosis; Young Adult
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