Browse publications by year: 2025

  1. Rahman NA, Rajaratnam V, Burchell GL, Morgan K, Abdullah MR, Zweekhorst MBM, et al.
    PLoS Negl Trop Dis, 2025 Apr;19(4):e0012959.
    PMID: 40168450 DOI: 10.1371/journal.pntd.0012959
    INTRODUCTION: Neglected tropical diseases (NTDs) comprise a group of twenty diverse diseases or conditions that pose significant public health challenges and adversely impact the quality of life of affected individuals. NTDs are characterised by interconnected biological, social, and environmental factors, which complicate their effective management and eradication. Collaborative research, such as transdisciplinary research (TDR) and participatory approaches that engage scientific, societal, and non-academic stakeholders in co-creating action-driven solutions offer promising strategies to address NTDs. These approaches bridge scientific research with community practices, ensuring evidence-based, contextually relevant interventions. Despite their potential, the application of these approaches in addressing NTDs remains underexplored. This scoping review explores the utilisation of TDR and participatory research approaches to address NTD-related challenges.

    METHODS: A systematic search was conducted in PubMed, Web of Science, Embase, and CINAHL, following the JBI methodology for scoping reviews. Data extraction and analysis were performed using JBI SUMARI software, focusing on peer-reviewed published literature reporting the use of TDR and participatory approaches in NTDs, with an emphasis on individual and community perspectives.

    RESULTS: The review examined seventeen articles from Africa, Asia, South America, and Australia, highlighting the increasing use of TDR and participatory approaches to address common NTDs such as leprosy, schistosomiasis, rabies, Buruli ulcer, and trypanosomiasis. These approaches engaged diverse stakeholders to develop practical, community-oriented solutions. Key strategies included enhancing public awareness, improving screening programmes, and implementing measures to control NTDs. However, challenges such as fragmented strategies and weak health systems hindered efforts to reduce the burden of NTDs.

    CONCLUSION: TDR and participatory approaches contribute to a holistic approach in addressing and managing NTD-related challenges by engaging diverse stakeholders and fostering a comprehensive understanding of community needs and on-the-ground realities. The findings demonstrate their effectiveness in translating evidence-informed knowledge into actionable interventions to benefit affected individuals and their communities.

    MeSH terms: Humans; Tropical Medicine*; Community-Based Participatory Research*
  2. Al Wade A, Hassan NH, Saaid M, Althakafy JT, Chong NS, Leong YH, et al.
    Food Chem, 2025 Mar 05;481:143720.
    PMID: 40168866 DOI: 10.1016/j.foodchem.2025.143720
    A dispersive liquid-liquid microextraction (DLLME) coupled to capillary electrophoresis with diode array detection (CE-DAD) for determination of sixteen phenolic compounds (PCs) is described. DLLME conditions that affect extraction performance were investigated using single-factor variable experiments. The PCs were extracted using ethyl acetate as extraction solvent and acetonitrile as dispersive solvent. The separation was achieved using fused-silica capillary with buffer constituted of 40 mmol L-1 borax (pH 9.3) and 10 % (v/v) ethanol. Voltage of 20 kV, cassette temperature of 25 °C, hydrodynamic injection (30 mbar for 6 s) and variable UV detection wavelengths were applied. The PCs were separated in < 32 min. Calibration curves were linear (r2 > 0.998) within 1-20 mg L-1 for naringin and catechin hydrate, and 0.3-20 mg L-1 for other PCs. Detection limits were 0.01-0.52 mg L-1, relative standard deviations of ≤ 2.39 % (migration times) and ≤ 5.66 % (peak areas) were obtained. The method exhibited good recoveries (85.2-110.7 %), with enrichment factors of 1.79-13.94 and greenness score of 0.35 (AGREEprep) and 0.54 (AGREE). The validated method was applied for determination of PCs in Tualang and stingless bee honey. These results demonstrated the potential of DLLME-CE-DAD as a simple, and environmentally friendly method to quantify PCs in SBH.
  3. Terborgh J, Ong L, Davenport LC, Tan WH, Solana Mena A, McConkey K, et al.
    Proc Biol Sci, 2025 Apr;292(2044):20242026.
    PMID: 40169019 DOI: 10.1098/rspb.2024.2026
    We report on a decade of research on elephant impacts in equatorial evergreen forests in Gabon and Malaysia, comparing sites with (+) and without (-) elephants and documenting major differences in forest structure, tree species composition and tree species diversity. In both regions, we compared sites supporting natural densities of elephants with otherwise undisturbed sites from which elephants had been absent for several decades. Elephant (+) sites supported low densities of seedlings and saplings relative to elephant (-) sites. In Lope National Park, Gabon, 88% of saplings and small trees (<20 cm dbh) were of species avoided by elephants, implicating forest elephants as powerful filters in tree recruitment. In Malaysia, Asian elephants showed strong preferences for monocots over dicots, as we found through both indirect and direct means. Loss of elephants from both Asian and African forests releases diversity from top-down pressure, as preferred forage species increase in abundance, leading to increased density of small stems and tree species diversity. In contrast, loss of other major functional groups of animals, including top carnivores, seed predators and seed dispersers, often results in negative impacts on tree diversity.
    MeSH terms: Animals; Conservation of Natural Resources; Gabon; Malaysia; Population Density; Trees*; Tropical Climate; Biodiversity*; Forests*
  4. Ooi JCE, Tan LS, Yong YX, Mahadi MI, Tang YL, Wee JS, et al.
    Pract Neurol, 2025 Apr 01.
    PMID: 40169252 DOI: 10.1136/pn-2025-004520
    A woman aged 49 years developed focal seizures, with right hemispheric focal slowing on electroencephalograph and right hemisphere focal cortical hyperintensities with subtle atrophy on MR brain scan. Cerebrospinal fluid identified anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor auto-antibodies, but her condition did not respond to immunotherapy for AMPA receptor encephalitis. Subsequent MR brain scan showed striking progressive unihemispheric atrophy, consistent with Rasmussen's encephalitis; she made a good functional recovery with cyclophosphamide. This case highlights the diagnostic and treatment challenges surrounding adult-onset Rasmussen's encephalitis. The unusual co-occurrence of anti-AMPA receptor autoantibody positivity emphasises the need for careful interpretation of such associations. It is important to think of Rasmussen's encephalitis as a spectrum of diseases with shared T-cell-mediated neuronal loss pathways but varying humoral components to understand this complex disease better.
  5. Fukushima R, Compher CW, Correia MITD, Gonzalez MC, McKeever L, Nakamura K, et al.
    Clin Nutr, 2025 Mar 28.
    PMID: 40169339 DOI: 10.1016/j.clnu.2025.03.011
    BACKGROUND: Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding.

    METHODS: The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement.

    RESULTS: CONCLUSION: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables at during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.

  6. Chen L, Jiang XD, Liu XP, Lee YZ, Tham CL, Yusof R, et al.
    Med Oncol, 2025 Apr 01;42(5):146.
    PMID: 40169432 DOI: 10.1007/s12032-025-02696-3
    Overexpression of Mcl-1 causes hepatocellular carcinoma resistance to Bcl-2 inhibitors, but there are currently no direct Mcl-1 inhibitors available for clinical application. Our previous research demonstrated that kaempferol from persimmon leaves (KPL) can sensitize ABT-199 to inhibit liver cancer cell proliferation. This study further explored the effect of KPL sensitizing ABT-199 on liver cancer cell apoptosis and its potential mechanisms. The inhibitory effects of KPL and ABT-199, both individually and in combination, on the proliferation of HepG2, Huh7, and HCCLM3 cells were evaluated. Cell apoptosis and mitochondrial morphology were assessed with flow cytometry and confocal microscopy, respectively. Apoptosis and changes in Mcl-1 protein expression were evaluated after siMcl-1 knockdown. Molecular docking simulations were used to analyze the interactions of KPL and ABT-199, both individually and in combination, with Mcl-1 protein. The effect of KPL on Mcl-1 stability was investigated with proteasome inhibitor MG132. The results demonstrated that KPL showed a strong sensitizing effect on ABT-199 (CI value 
    MeSH terms: Antineoplastic Agents/pharmacology; Drug Synergism; Humans; Plant Leaves*; Cell Line, Tumor; Cell Proliferation/drug effects; Hep G2 Cells; Molecular Docking Simulation*
  7. Saeed A, Tasleem Z, Muhammad SA, Ur Rehman A, Shah S, Jamil QA, et al.
    Pharmacoecon Open, 2025 Apr 01.
    PMID: 40169494 DOI: 10.1007/s41669-024-00554-y
    BACKGROUND: Acute myeloid leukemia (AML) is a heterogenous malignancy whose management is associated with considerable healthcare resource utilization and high expenditures because of recurrent and extended hospitalizations, multiple outpatient visits, and a wide range of supportive care. Modern therapies with improved safety profiles may assist in reducing healthcare costs; however, they are usually more expensive than standard chemotherapies. Few studies have addressed the expenses and burden of AML. Most of these studies were conducted in the USA. Very little research is available from the European Union (EU).

    OBJECTIVES: The aim of this study was to assess the economic impact of AML and determine the major cost-driving factors for its treatment in the EU.

    METHODS: This systematic review is in accordance with PRISMA guidelines. A systematic search was conducted using PubMed, Embase, ScienceDirect, SCOPUS, and Google Scholar databases to identify relevant studies on the economic impact of AML in various countries of the EU, published before April 15, 2024. Original studies investigating direct costs including expenses for treatment and healthcare services, or resource utilization for AML management were included. The systematic review excluded commentaries, editorials, and pharmacoeconomic modeling studies. Two reviewers independently performed data extraction and quality assessment, and the third reviewer resolved disagreements. We employed the Allison Larg Cost-of-Illness Studies evaluation checklist to assess the risk of bias. The mean cost per patient for induction, consolidation, and transplantation was calculated, and the results were converted into 2024 Euros.

    RESULTS: Twenty-eight studies met our inclusion criteria, with the sample size of AML patients ranging from 12 to 39,568. The calculated per-patient direct costs of induction chemotherapy in Spain, France, Netherlands, Germany, and Italy were €92,378, €77,844, €61,643, €46,113, and €20,254, respectively. The mean per-patient direct cost of consolidation chemotherapy in the Netherlands and Germany was €42,137, and €32,220, respectively. The mean per-patient direct costs of transplantation in Sweden, Austria, France, Netherlands, and Spain were €192,628, €188,453, €132,352, €122,760, and €47,968, respectively. The cost-driving factors associated with AML treatment were inpatient hospitalization and medication costs.

    CONCLUSION: AML seems to incur substantial direct economic expenses. Reducing the days of hospitalization can significantly decrease the economic burden of AML in the European Union. Moreover, there is a necessity for studies that comprehensively evaluate the economic implications, particularly concerning total and indirect costs.

    REGISTRATION: Registered in PROSPERO under the registration number 'CRD42024537725'.

  8. Qiu H, Al-Nussairi AKJ, Chevinli ZS, Singh Sawaran Singh N, Chyad MH, Yu J, et al.
    Sci Rep, 2025 Apr 01;15(1):11078.
    PMID: 40169713 DOI: 10.1038/s41598-025-91243-1
    This paper presents an innovative approach to enhancing the adaptive control of automotive suspension systems by integrating digital twin (DT) technology with artificial neural networks (ANNs). The proposed method leverages real-time data from DTs to dynamically adjust the suspension settings, optimizing ride comfort and vehicle handling. A detailed simulation model of a vehicle's suspension system was developed using MATLAB/Simulink, with the DT providing continuous feedback to the ANN-based adaptive controller. The effectiveness of the proposed method was evaluated through a series of simulations under various road conditions and driving scenarios. Results show that the integrated DT and ANN approach improves ride comfort by 8.46% compared to traditional Proportional-Integral-Derivative (PID) control methods, as measured by the reduction in vertical acceleration of the vehicle's body. Additionally, vehicle handling was enhanced by 14.02%, demonstrated by a decrease in the lateral acceleration during cornering. The predictive maintenance capability of the system also showed a 5.72% reduction in suspension component wear, extending the overall lifespan of the system. These findings suggest that the integration of DTs with neural networks (NN) offers significant improvements in both the performance and longevity of automotive suspension systems, providing a compelling case for further development and real-world implementation.
  9. Sun M, Soh KG, Cao S, Yaacob AB, Ma S, Ding C
    BMC Sports Sci Med Rehabil, 2025 Apr 02;17(1):66.
    PMID: 40170059 DOI: 10.1186/s13102-025-01101-w
    BACKGROUND: Previous studies have demonstrated the effects of SAQ training on sprint, change-of-direction, and jump performance in soccer players. However, further research is needed to assess its broader impact on different athletic populations and performance metrics. This study aims to expand the existing evidence by incorporating a wider range of outcomes and providing a more comprehensive analysis of SAQ training effects.

    METHODS: A thorough search of databases, including Web of Science Core, SPORTDiscus, PubMed, and SCOPUS, was conducted, with data up to July 2024. The PEDro scale assessed study quality and RevMan 5.3 evaluated bias risk. Effect sizes (ES) were calculated from means and standard deviations, with heterogeneity assessed using the I² statistic. Publication bias was evaluated using an extended Egger test.

    RESULTS: Eleven RCTs involving 499 healthy athletes from sports such as soccer, basketball, tennis, and handball met the inclusion criteria. The SAQ interventions lasted between 4 and 12 weeks, with a frequency of two to three sessions per week. The analysis revealed significant improvements in 5-meter sprint (ES = 0.63, p 60 min: ES = 0.24; p = 0.059).

    CONCLUSIONS: SAQ training effectively enhances sprint performance, COD ability, reaction time, lower limb strength, and flexibility, with effect sizes ranging from small to moderate. The findings suggest that shorter training durations (≤ 60 min) may be more beneficial for improving COD performance, although this effect did not reach statistical significance. Further trials are recommended to determine the optimal training dosage, along with high-quality studies covering a broader range of sports, particularly in athletes aged 14 to 18.

  10. Chen J, Chong MC, Nant Thin Thin H, Xu F, Dong X, Yang X, et al.
    Brain Behav, 2025 Apr;15(4):e70464.
    PMID: 40170548 DOI: 10.1002/brb3.70464
    BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9), known for its brevity and ease of use, is employed by researchers and clinical practitioners for poststroke depression (PSD) screening. However, the effectiveness of the PHQ-9 in PSD screening remains to be further validated.

    METHODS: Electronic searches were conducted in EMBASE, PubMed, Web of Science, CNKI, and Wanfang databases using keywords including stroke, depression, and PHQ-9. The assessment tool Quality Assessment of Diagnostic Accuracy Studies-2 was utilized to evaluate the risk of bias in diagnostic studies.

    RESULTS: A total of 2049 articles were retrieved, with 9 meeting the inclusion criteria. The PHQ-9 demonstrated pooled sensitivity and specificity of 0.84 and 0.90, respectively, and a summary receiver operating characteristic (sROC) curve of 0.93. At the 10-cut-off value, pooled sensitivity, specificity, and sROC were 0.77, 0.85, and 0.86, respectively. At the 9-cut-off value, the sensitivity, specificity, and sROC were 0.87, 0.85, and 0.92, respectively. At the 5-cut-off value, sensitivity, specificity, and sROC are 0.90, 0.91, and 0.96, respectively. No publication bias was identified.

    CONCLUSION: The PHQ-9 is an effective tool for screening poststroke depressive symptoms with significant clinical utility. However, further research is needed to establish optimal diagnostic thresholds.

    MeSH terms: Humans; Sensitivity and Specificity; Reproducibility of Results
  11. Yeoh WC, Banavar SR, Rajaran JR, Siew KL
    Cureus, 2025 Mar;17(3):e79907.
    PMID: 40171350 DOI: 10.7759/cureus.79907
    Actinomycosis is an insidious infection caused by the facultative anaerobic Gram-positive bacterium Actinomyces, commonly found in the oral microbiome. Among its manifestations, periapical actinomycosis stands out as a rare subtype within cervicofacial actinomycosis, speculated to play a role in the persistence of periapical radiolucencies following root canal therapy. Instances of this occurrence often arise from disruptions in epithelial continuity, stemming from surgical procedures, trauma, or prior infections, paving the way for deep microbial infiltration. A 35-year-old woman presented with persistent pain and swelling in the premolar region of her mandible. Examination unveiled a radiolucent lesion in an endodontically treated premolar. The tooth remained symptomatic, and the draining sinus tract persisted despite multiple attempts at disinfecting and re-medicating the canal. A subsequent apicoectomy was performed, yielding promising outcomes, with satisfactory periapical healing observed at both the 6- and 12-month follow-up evaluations.
  12. Vasudayan SR, Loo GH, Muthkumaran G, Ritza Kosai N
    Cureus, 2025 Mar;17(3):e79928.
    PMID: 40171375 DOI: 10.7759/cureus.79928
    Intragastric balloon (IGB) placement is a widely used, minimally invasive intervention for obesity and metabolic disorders, offering a temporary, reversible alternative for weight management. It is generally well tolerated, with most complications being mild and self-limiting, such as nausea, vomiting, and abdominal discomfort. However, in rare cases, more serious complications can arise, including gastric ulceration, balloon migration, and, in extreme cases, gastric perforation. The latter can occur at any time from days to months after insertion, necessitating prompt recognition and surgical intervention to prevent life-threatening consequences. We report a case of a 47-year-old woman who presented with an acute abdomen four months after IGB insertion. Imaging revealed a hyperinflated IGB with associated gastric perforation. The patient was urgently taken to the operating room, where an on-table esophagogastroduodenoscopy confirmed the findings. Laparoscopic primary repair was performed following balloon removal. The mechanism behind IGB hyperinflation remains multifactorial. Computed tomography is the preferred imaging modality for diagnosis. In bariatric centers, a minimally invasive approach, combining endoscopic balloon removal with laparoscopic perforation repair, has demonstrated superior outcomes compared to open surgery, reducing morbidity and recovery time. Endoscopic balloon removal combined with laparoscopic repair offers significant advantages, including minimal scarring, faster recovery, and shorter hospital stays. Early detection and a multidisciplinary approach are crucial for optimal patient outcomes.
  13. Müller A, Wouters EFM, Burney P, Potts J, Cardoso J, Al Ghobain M, et al.
    Pulmonology, 2025 Dec 31;31(1):2470566.
    PMID: 40171577 DOI: 10.1080/25310429.2025.2470566
    INTRODUCTION: Evidence of an association between breathlessness and quality of life from population-based studies is limited. We aimed to investigate the association of both physical and mental quality of life with breathlessness across several low-, middle- and high-income countries.

    METHODS: We analysed data from 19 714 adults (31 sites, 25 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We measured both mental and physical quality of life components using the SF-12 questionnaire, and defined breathlessness as grade ≥2 on the modified Medical Research Council scale. We used multivariable linear regression to assess the association of each quality-of-life component with breathlessness. We pooled site-specific estimates using random-effects meta-analysis.

    RESULTS: Both physical and mental component scores were lower in participants with breathlessness compared to those without. This association was stronger for the physical component (coefficient = -7.59; 95%CI -8.60, -6.58; I2 = 78.5%) than for the mental component (coefficient = -3.50; 95%CI -4.36, -2.63; I2 = 71.4%). The association between physical component and breathlessness was stronger in high-income countries (coefficient = -8.82; 95%CI -10.15, -7.50). Heterogeneity across sites was partly explained by sex and tobacco smoking.

    CONCLUSION: Quality of life is worse in people with breathlessness, but this association varies widely across the world.

    MeSH terms: Adult; Aged; Cross-Sectional Studies; Developing Countries; Female; Humans; Male; Middle Aged; Surveys and Questionnaires; Developed Countries/statistics & numerical data; Pulmonary Disease, Chronic Obstructive/complications; Pulmonary Disease, Chronic Obstructive/epidemiology; Pulmonary Disease, Chronic Obstructive/physiopathology; Pulmonary Disease, Chronic Obstructive/psychology
  14. Ng CT, Fong LY, Tan JJ, Abdullah MNH
    Cytokine, 2025 Mar 29;190:156922.
    PMID: 40158467 DOI: 10.1016/j.cyto.2025.156922
    Crosstalk and synergy between interferon-γ (IFN-Ƴ) and tumor necrosis factor-α (TNF-α) in endothelial cells have previously been documented, however, there is an absence of articles reviewing the synergistic effect of IFN-Ƴ and TNF-α in regulating the endothelial barrier function. This review discusses the regulatory mechanisms and recent evidence of the synergism of IFN-γ and TNF-α in causing destabilization of endothelial junctions in various clinical studies and preclinical models. Articles were retrieved from electronic databases such as Web of Science, PubMed, Google Scholar, and Scopus. The search terms used were "interferon", "interferon-gamma", "tumor necrosis factor-α", "vascular inflammation", "endothelial barrier", "endothelial permeability" and "synergism". We selected articles published between 2004 and 2024. Through the Rho-associated protein kinase (ROCK) and p38 mitogen-activated protein (MAP) kinase pathways, our results showed that IFN-γ controls the remodeling of actin and the stability of junctions. In comparison to IFN-γ, the signaling cascades triggered by TNF-α involve a variety of pathways such as nuclear factor-kappa B (NF-κB), small GTPases, tyrosine kinases, integrin receptors, and barrier-stabilizing molecules such as Ras-related proteins 1A (Rap1A) and Rac family small GTPase 1 (Rac1). In the context of IFN-γ and TNF-α synergism, combined IFN-γ and TNF-α alter adherens and tight junctions. It is deduced that c-Jun N-terminal kinase (JNK), signal transducers and activators of transcription (STAT1), and caspase signaling pathways regulate endothelial barrier disruption caused by IFN-γ and TNF-α. Collectively, the mechanism underlying the synergistic action of IFN-γ and TNF-α is still lacking. Future work is needed to explore the crosstalk pathways of IFN-γ and TNF-α involved in the regulation of endothelial barrier function such as modulation of extracellular matrix (ECM) structure, involvement of tyrosine kinases and roles of small GTPases.
  15. Al-Bazali A, Joshi A, Manchanda DY
    J Am Acad Dermatol, 2025 Mar 28.
    PMID: 40158539 DOI: 10.1016/j.jaad.2025.03.064
    Syphilis has been labelled as a 'Great Imitator'. The clinical manifestations of syphilis are largely mucocutaneous lesions, thus dermatologists are well placed to be able to diagnose it. However, the secondary stage of syphilis can have myriad presentations, and can easily be misdiagnosed even by an experienced dermatologist. The dermatologists should be aware of rarer morphological variants of the disease.
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