Browse publications by year: 2025

  1. Tan YJ, Jamil A, Gunabalasingam P
    PMID: 39949652 DOI: 10.51866/oa.622
    INTRODUCTION: Acne is a common chronic inflammatory disease. Misconceptions hinder effective management. This study aimed to explore disease perception, treatment-seeking behaviour and the psychosocial impact of acne.

    METHODS: A cross-sectional study was conducted in four universities. A self-administered questionnaire was developed and validated. During clinical examination, acne severity was determined using the Comprehensive Acne Severity Scale (CASS) and psychosocial impact using the Cardiff Acne Disability Index (CADI).

    RESULTS: Four hundred students with acne aged 20±1.62 years participated, among whom 62.5% were women. The self-perceived acne severity matched the CASS score in 54.4% of the participants but was worse in 37.5%. Approximately 80.5% correctly recognised acne as a disease, while beliefs about its chronicity varied. The aggravating factors were food (92.8%), genetic predisposition (92.8%), stress (91.3%), hygiene (86.3%) and menstruation (84.8%). The information sources were families (79.7%), online social media platforms (60.2%) and friends (58.5%). Doctor consultation was significantly associated with correct disease perception, severe disease and higher psychosocial impact. Cost was the commonest deterrent for seeking (63.8%) and discontinuing treatment (43.2%). The psychosocial impact was predominantly mild (71%). The CADI domains mostly affected were feelings and psychological state. The clinical (odd ratio [OR] =2.29, 95% confidence interval [CI] = 1.45, 3.61) and self-perceived acne severity (OR=4.83, 95% CI=2.79, 8.35) predicted a higher psychosocial impact.

    CONCLUSION: Misconceptions about acne as a disease were not prevalent, and aggravating factors other than food were correctly identified. Common information sources may further perpetuate misconceptions. Financial treatment barriers should be addressed especially in patients with severe acne and psychosocial impacts.

  2. Mowoe MO, Allam H, Nqada J, Bernon M, Gandhi K, Burmeister S, et al.
    Front Immunol, 2025;16:1494446.
    PMID: 39949781 DOI: 10.3389/fimmu.2025.1494446
    INTRODUCTION: New biomarkers are urgently needed to detect pancreatic ductal adenocarcinoma (PDAC) at an earlier stage for individualized treatment strategies and to improve outcomes. Autoantibodies (AAbs) in principle make attractive biomarkers as they arise early in disease, report on disease-associated perturbations in cellular proteomes, and are static in response to other common stimuli, yet are measurable in the periphery, potentially well in advance of the onset of clinical symptoms.

    METHODS: Here, we used high-throughput, custom cancer antigen microarrays to identify a clinically relevant autoantibody biomarker combination able to differentially detect PDAC. Specifically, we quantified the serological AAb profiles of 94 PDAC, chronic pancreatitis (CP), other pancreatic- (PC) and prostate cancers (PRC), non-ulcer dyspepsia patients (DYS), and healthy controls (HC).

    RESULTS: Combinatorial ROC curve analysis on the training cohort data from the cancer antigen microarrays identified the most effective biomarker combination as CEACAM1-DPPA2-DPPA3-MAGEA4-SRC-TPBG-XAGE3 with an AUC = 85·0% (SE = 0·828, SP = 0·684). Additionally, differential expression analysis on the samples run on the iOme™ array identified 4 biomarkers (ALX1-GPA33-LIP1-SUB1) upregulated in PDAC against diseased and healthy controls. Identified AAbs were validated in silico using public immunohistochemistry datasets and experimentally using a custom PDAC protein microarray comprising the 11 optimal AAb biomarker panel. The clinical utility of the biomarker panel was tested in an independent cohort comprising 223 PDAC, PC, PRC, colorectal cancer (CRC), and HC samples. Combinatorial ROC curve analysis on the validation data identified the most effective biomarker combination to be CEACAM1-DPPA2-DPPA3-MAGEA4-SRC-TPBG-XAGE3 with an AUC = 85·0% (SE = 0·828, SP = 0·684). Subsequently, the specificity of the 11-biomarker panel was validated against other cancers (PDAC vs PC: AUC = 70·3%; PDAC vs CRC: AUC = 84·3%; PDAC vs PRC: AUC = 80·2%) and healthy controls (PDAC vs HC: AUC = 80·9%), confirming that this novel AAb biomarker panel is able to selectively detect PDAC amongst other confounding diseases.

    CONCLUSION: This AAb panel may therefore have the potential to form the basis of a novel diagnostic test for PDAC.

    MeSH terms: Adult; Aged; Antigens, Neoplasm/immunology; Diagnosis, Differential; Female; Humans; Male; Middle Aged; ROC Curve; Protein Array Analysis
  3. Zafar RF, Khoo MBC, You HW, Saha S, Yeong WC
    J Appl Stat, 2025;52(3):744-777.
    PMID: 39950017 DOI: 10.1080/02664763.2024.2392122
    A partitioned weighted moving average (PWMA) chart is developed by partitioning the samples (or observations) into two groups, calculating the groups' weighted average and adding them. This partitioning gives more control over weight distribution in the most recent j (= 2, 3, …) samples. The PWMA, exponentially weighted moving average (EWMA) and homogenously weighted moving average (HWMA) charts are compared. For zero state, the PWMA chart outperforms the EWMA and HWMA charts for most (n, λ, δ) values and the outperformance of the former over the two latter charts increases with the time period (j), employed in the partitioning. Here, λ is the charts' smoothing constant and δ is the shift size (multiples of standard deviation). For steady state, the PWMA chart (regardless of j) generally outperforms the EWMA chart in detecting a small shift (δ = 0.25) when the smoothing constant λ ≥ 0.2 for the sample size n = 1; while a larger λ is needed for n = 5. Moreover, for steady state, the PWMA chart outperforms the HWMA chart in detecting small and moderate shifts (0.25 ≤ δ ≤ 1), regardless of (λ, n, j). The PWMA chart demonstrates robustness to non-normality and estimated process parameters.
  4. Mitsuwan W, Sama-Ae I, Sangkanu S, Khan DA, Biswas P, Hasan MN, et al.
    Scientifica (Cairo), 2025;2025:4311313.
    PMID: 39950149 DOI: 10.1155/sci5/4311313
    Medicinal plants have been used as alternative agents for the treatment of infections. This study aimed to investigate bioactivities of medicinal plant extracts including Knema retusa extract (Kre) against Acanthamoeba triangularis T4 in vitro and in silico. Anti-Acanthamoeba activities of 44 extracts from 5 plant species were determined. From 44 tested extracts, a chloroform extract of Kre bark showed the strongest anti-Acanthamoeba activities against both trophozoites and cysts, with MIC values of 32.25 and 62.50 μg/mL, respectively. Then, amebicidal and antiadhesion activities of Kre against A. triangularis were investigated. Kre reduced the growth by 3 logs within 8 h at 4 × MIC. Disruption of the cells with abnormal shapes was observed when trophozoites were treated with Kre. Trophozoites had lost their robust acanthopodia and began to shrink after treatment with Kre. Treated cysts exhibited wall disruption and dramatically showed forms of marked retraction. Treatment of Kre at 1/2 × MIC showed about 87% reduction in the trophozoite adhesion, while treatment at 2 × MIC exhibited a 59% reduction in the trophozoite adhesion to the plastic surface, compared with the control. Furthermore, 1 log cells/mL (90%) of the contact lens adhesive trophozoites were reduced and removed after treatment with Kre. Molecular docking indicated that E2N, the main compound in Kre, exhibited strong binding to the ligand binding sites at β-tubulin, with a binding energy of -7.01 kcal/mol and an inhibitory constant of 2.43-7.32 μM. E2N generated multiple connections via hydrogen, hydrophobic, ionic, and water bridge bonding and maintained these connections until the simulation finished, facilitating the creation of stable bindings with the β-tubulin protein as measured by molecular dynamics simulation. These findings suggest that Kre exhibits amebicidal and antiadhesion activities which could be used for the prevention of A. triangularis adhesion to contact lenses.
  5. Tran TA, Mattap SM, Warren N, Teng JHJ, Duong MD, Hoang VM, et al.
    Aging Ment Health, 2025 Feb 14.
    PMID: 39950199 DOI: 10.1080/13607863.2025.2462110
    OBJECTIVES: Long-term caregiving can lead to a high caregiver burden for caregivers of community-dwelling people with dementia in Asia's low- and middle-income countries (LMICs). It is essential to assess the level of caregiver burden and its factors in such settings to understand the impact on caregivers' well-being.

    METHOD: A systematic review was conducted based on the PRISMA. Articles were identified from seven databases published from 2000 to November 2023. Each article's methodological quality was assessed with an appraisal checklist developed by the Joanna Briggs Institute.

    RESULTS: 64 studies with 12 measurement tools were identified from 9 countries. Only 20% of studies using 22-item ZBI show caregivers experienced no or little burden while caring for their care recipients. The mean 22-item ZBI score ranged from 24.5 in Turkey to 34.7 in India, while the mean CBI score varied from 24.0 in Thailand to 47.8 in China. Patient, caregiver characteristics, and caregiving context are associated with caregiver burden.

    CONCLUSION: Dementia caregivers in Asian LMICs exhibit a wide variation in caregiver burden. Programs that promote protective factors and address modifiable factors are imperative to mitigate burdens and enhance caregivers' quality of life in these settings.

  6. Khalid AQ, Zaidan TN, Bhuvanendran S, Magalingam KB, Mohamedahmed SM, Ramdas P, et al.
    Nutr Rev, 2025 Mar 01;83(3):e1295-e1310.
    PMID: 39181121 DOI: 10.1093/nutrit/nuae108
    Colorectal cancer (CRC) is a growing concern all over the world. There has been a concerted effort to identify natural bioactive compounds that can be used to prevent or overcome this condition. Tocotrienols (T3s) are a naturally occurring form of vitamin E known for various therapeutic effects, such as anticancer, antioxidant, neuroprotective, and anti-inflammatory activities. The literature evidence suggests that two T3 analogues, ie, gamma (γ)- and delta (δ)-T3, can modulate cancers via several cancer-related signaling pathways. The aim of this review was to compile and analyze the existing literature on the diverse anticancer mechanisms of γT3 and δT3 exhibited in CRC cells, to showcase the anticancer potential of T3s. Medline was searched for research articles on anticancer effects of γT3 and δT3 in CRC published in the past 2 decades. A total of 38 articles (26 cell-based, 9 animal studies, 2 randomized clinical trials, and 1 scoping review) that report anticancer effects of γT3 and δT3 in CRC were identified. The findings reported in those articles indicate that γT3 and δT3 inhibit the proliferation of CRC cells, induce cell cycle arrest and apoptosis, suppress metastasis, and produce synergistic anticancer effects when combined with well-established anticancer agents. There is preliminary evidence that shows that T3s affect telomerase functions and support anticancer immune responses. γT3 and δT3 have the potential for development as anticancer agents.
    MeSH terms: Animals; Antineoplastic Agents/pharmacology; Chromans; Humans; Vitamin E/analogs & derivatives; Vitamin E/pharmacology; Signal Transduction/drug effects; Apoptosis/drug effects; Tocotrienols/pharmacology
  7. Akhbar Anugrah F, Nyoman Pugeg Aryantha I, Masita R, Zubaidah S, Izzati Mohd Noh N
    J Gen Appl Microbiol, 2025 Feb 13;70(4).
    PMID: 39462602 DOI: 10.2323/jgam.2024.09.002
    For centuries, quinoline alkaloids from the tree bark of Cinchona ledgeriana (C. ledgeriana) have been used in the treatment of malaria. However, unsustainable harvesting and poor growth conditions greatly limit its use as raw materials. Since plant endophytes are known to contribute to the physiology of the host and its metabolism for survival, this study showed the potential of endophytes isolated from C. ledgeriana roots in promoting the germination of Catharathus roseus (C. roseus) seedlings and the biosynthesis of quinoline alkaloid. In this present study, we found that the Enterobacteriaceae family comprised the majority of the bacterial community, with Klebsiella pneumoniae being the most abundant species at the C. ledgeriana roots. Characterization of culturable bacterial endophytes from the C. ledgeriana roots showed that all the isolates displayed plant growth-promoting factors and antifungal activities. Interestingly, chromatographic analyses led to the identification of the quinoline alkaloids producing Achromobacter xylosoxidans (A. xylosoxidans) A1. Moreover, the co-cultures of A. xylosoxidans A1, Cytobacillus solani (C. solani) A3, and Klebsiella aerogenes A6 increased the fresh and dry weight of the C. roseus seedlings. These results suggest that these bacterial endophytes may enhance quinine and quinidine production as well as the growth of the plant host.
    MeSH terms: Antifungal Agents/isolation & purification; Antifungal Agents/metabolism; Antifungal Agents/pharmacology; Bacteria/classification; Bacteria/growth & development; Bacteria/isolation & purification; Bacteria/metabolism; Enterobacteriaceae/growth & development; Enterobacteriaceae/isolation & purification; Enterobacteriaceae/metabolism; Plant Growth Regulators/metabolism; Germination; Seedlings/growth & development; Seedlings/microbiology
  8. Zhang X, Wang L, Shafian S, Wang P, Zhao Y, Wang P, et al.
    Small, 2025 Feb;21(6):e2408362.
    PMID: 39718213 DOI: 10.1002/smll.202408362
    Perovskite solar cells (PSCs) have achieved impressive efficiency, but their commercialization is limited by issues like chemical homogeneity within the perovskite films, leading to defects and phase segregation, which severely compromise the stability and performance of PSCs. This study presents a novel approach to overcoming these barriers by employing N,N-methylenebisacrylamide (MBA) as a multifunctional crosslinking agent within the perovskite structure. MBA enhances chemical uniformity both laterally and vertically, improves crystallinity, and boosts overall film stability by forming a robust crosslinked network that regulates nucleation and growth dynamics during the pre-seeding process. This modification ensures a uniform distribution within the perovskite matrix and significantly reduces defect densities. As a result, MBA-treated PSCs achieved a notable improvement in power conversion efficiency (PCE), reaching up to 24.26%, compared to 22.64% in control devices. Additionally, the MBA-modified devices demonstrated remarkable stability, maintaining 90% of their initial efficiency after 1200 h of continuous illumination, in contrast to the 50% efficiency loss observed in control devices after just 500 h. These findings underscore the transformative potential of MBA as an additive in PSCs, offering a viable pathway to not only enhance efficiency but also significantly improve the long-term stability of these devices, thus bringing PSCs closer to commercial viability.
  9. Patel VK, Shirbhate E, Singh V, Parveen S, Veerasamy R, Tiwari AK, et al.
    Curr Top Med Chem, 2025 Feb 06.
    PMID: 39936438 DOI: 10.2174/0115680266324868250123052818
    Anti-angiogenic therapy represents a promising approach to cancer treatment by targeting the vascular support systems of tumors rather than the tumor cells themselves. Antiangiogenic agents face numerous obstacles that impede their efficacy, notwithstanding their potential: mechanistic complexity, toxicity, resistance, and the lack of validated predictive biomarkers. Resistance mechanisms may encompass genetic modifications, alternative angiogenic pathways, or the recruitment of cells derived from bone marrow. This work examines present problems and approaches to overcome resistance against anti-angiogenic treatment. Treatment response is predicted by biomarker-guided therapy; patterns of circulating endothelial cells, IL-8 levels, and VEGFR expression indicate possible therapeutic monitoring value. Multi-targeted approaches including drugs that block VEGFR, PDGFR, FGFR, and c-MET concurrently have shown more efficacy than single- pathway inhibition. Additional research indicates that combining treatments has positive results. Combining anti-angiogenic agents with cancer vaccines increases immune responses and tumour regulation. Combining radiotherapy with chemotherapy increases drug delivery and efficacy utilizing vascular normalisation. Techniques based on nanotechnology such as gold nanoparticles and carbon-based materials may enhance medicinal efficacy and delivery. These results reveal that to overcome resistance mechanisms and enhance patient outcomes anti-angiogenic therapy must combine focused therapies with precision medicine approaches.
  10. Wu S, Pan JW, Citartan M, Tang TH, MyBrCa Collaborative Group, Teo SH, et al.
    Genes Chromosomes Cancer, 2025 Feb;64(2):e70027.
    PMID: 39936877 DOI: 10.1002/gcc.70027
    Breast cancer, a molecularly heterogeneous disease, is classified into hormone receptor-positive luminal breast cancer (LBC), human epidermal growth factor receptor 2-positive breast cancer, and triple-negative breast cancer (TNBC). Precursor microRNAs (pre-miRNAs), typically form hairpin structures with a length from 65 to 80 bases, are shown to play crucial roles in breast cancer carcinogenesis. We hypothesized that these pre-miRNAs could have been sequenced in total RNA sequencing (RNA-seq) and developed a novel algorithm to profile pre-miRNAs from raw total RNA-seq data. A total of 907 breast cancer samples curated by Malaysian Breast Cancer Genetic Study (MyBrCa) were profiled using this algorithm and a comparison was made between pre-miRNA profiles and mature miRNA profiles obtained from The Cancer Genome Atlas (TCGA) dataset. We explored differentially expressed pre-miRNAs in TNBC in comparison to LBC and conducted downstream functional analyses of the target genes. A prognostic signature was built by LASSO-Cox regression on selected pre-miRNAs and validated internally and externally by MyBrCa and TCGA datasets, respectively. As a result, 10 common differentially expressed pre-miRNAs were identified. Functional analyses of these pre-miRNAs captured certain aggressive TNBC behaviors. Importantly, a pre-miRNA signature composed of 4 out of these 10 pre-miRNAs significantly prognosticated the breast cancer patients in the MyBrCa cohort and TCGA cohort, independent of conventional prognostic factors. In conclusion, this novel algorithm allows profiling pre-miRNAs from raw total RNA-seq data, which could be cross-validated with mature miRNA profiles for cross-platform comparison. The findings of this study underscore the importance of pre-miRNAs in breast cancer carcinogenesis and as prognostic factors.
    MeSH terms: Algorithms; Female; Humans; Middle Aged; Prognosis; RNA Precursors/genetics; Biomarkers, Tumor/genetics; Gene Expression Regulation, Neoplastic; Sequence Analysis, RNA/methods; Gene Expression Profiling/methods; Triple Negative Breast Neoplasms/genetics; Triple Negative Breast Neoplasms/pathology
  11. Wan J, Kim SB, Yoon SE, Jalali A, Thulesen J, Frank K, et al.
    Aesthetic Plast Surg, 2025 Feb 12.
    PMID: 39937230 DOI: 10.1007/s00266-025-04708-z
    Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .
  12. Ngadimon IW, Mohan D, Shaikh MF, Khoo CS, Tan HJ, Lee YM, et al.
    Epilepsia Open, 2025 Feb 12.
    PMID: 39937590 DOI: 10.1002/epi4.70001
    OBJECTIVE: Posttraumatic epilepsy (PTE) and cognitive impairment are severe complications following traumatic brain injury (TBI). Neuroinflammation likely contributes, but the role of specific inflammatory mediators requires clarification. High-mobility group box 1 (HMGB1) is an inflammatory cytokine released after brain injury that may be involved. This prospective longitudinal study investigated whether serum HMGB1 levels are associated with PTE development and cognitive decline over 12 months post-TBI.

    METHODS: Serum samples were collected from 41 TBI patients, including mild and moderate to severe, at baseline, 6, and 12 months following TBI. HMGB1 was quantified by ELISA alongside interleukin-1β (IL-1β) and tumor necrosis factor (TNF). Cognitive assessments using validated neuropsychological assessments were performed at 6 and 12 months. The occurrence of PTE was also tracked.

    RESULTS: HMGB1 remained elevated at 12 months post-TBI only in the subgroup (n = 6) that developed PTE (p = 0.026). PTE was associated with moderate to severe TBI cases. Higher HMGB1 levels at 12 months correlated with a greater decline in Addenbrooke's Cognitive Examination scores (p 

  13. Saeed K, Chughtai MFJ, Ahsan S, Mehmood T, Khalid MZ, Khaliq A, et al.
    J Am Nutr Assoc, 2025 Feb 12.
    PMID: 39937610 DOI: 10.1080/27697061.2024.2442615
    OBJECTIVE: Chronic liver diseases are accountable for approximately 2 million deaths annually. The current study aimed to test the putative prophylactic role of Kalanchoe pinnata against hepatic stress.

    METHOD: Kalanchoe pinnata leaf extracts utilized in beverage production were obtained via 3 different extraction techniques (conventional solvent extraction, supercritical fluid extraction, microwave-assisted extraction).

    RESULTS: The highest values on 2,2-diphenyl-1-picrylhydrazyl, ferric reducing antioxidant power, and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid assay were from a beverage prepared with supercritical fluid extract. When the prophylactic aspects of a Kalanchoe pinnata-based beverage were explored against carbon tetrachloride- (CCl4-) and gentamicin-induced hepatotoxic conditions in male Wistar rats, results revealed a reduction in serum aspartate aminotransferase, serum alkaline phosphatase, serum alanine transaminase, and bilirubin levels in rats with CCl4 and gentamicin-induced toxicity. The study also concluded that the administration of a therapeutic beverage significantly improved serum total protein, albumin, and globulin levels in Kalanchoe pinnata-treated rats.

    CONCLUSIONS: Our findings support the ameliorative potential of Kalanchoe pinnata against liver diseases.

  14. Wan Mokhter WM, Duan X, Yang J, Mohamed Daud MA
    PLoS One, 2025;20(2):e0313557.
    PMID: 39937772 DOI: 10.1371/journal.pone.0313557
    BACKGROUND: To investigate the risk factors for urethral stricture (US) in patients with benign prostatic hyperplasia (BPH) after transurethral resection of the prostate (TURP) and to construct a nomogram model with predictive features.

    METHODS: Clinical data of 400 patients with BPH who underwent TURP between June 2020 and June 2023 at Chengdu University Hospital were retrospectively collected. The data were divided into US group and no US group. Univariate and multivariate logistic regression analyses were performed sequentially to identify independent risk factors associated with US. Based on the results of the multivariate analysis, a nomogram model predicting the risk of US was constructed. We assessed the discriminatory power and calibration of the models using the C index, ROC curves, and calibration plots. In addition, we performed a decision curve analysis to validate the clinical utility of the model.

    RESULTS: Data from a total of 400 patients were included in this study, and 35 (8.75%) were diagnosed with US. The results of univariate and multivariate analyses indicated that the following five factors age, prostate size, Preoperative indwelling catheter, Preoperative urethral dilation, Postoperative indwelling catheter time were independent influences on the risk of US. Nomogram model of US was constructed using these independent influences. The area under the curve (AUC) of the subject's operating characteristic was 0.916 (95% CI: 0.868-0.959), and after internal validation, the corrected C-index remained at 0.916. This further validates the accuracy and reliability of the predictive model. Calibration plots and decision curve analyses demonstrated the good clinical value of the column-line diagram model.

    CONCLUSIONS: The nomogram model we constructed can have some guidance in clinical work.

    MeSH terms: Aged; Humans; Male; Middle Aged; Postoperative Complications/diagnosis; Postoperative Complications/etiology; Postoperative Complications/epidemiology; Retrospective Studies; Risk Factors; ROC Curve; Nomograms*
  15. Maqbool T, Ishaq H, Shakeel S, Zaib Un Nisa A, Rehman H, Kashif S, et al.
    PLoS One, 2025;20(2):e0314045.
    PMID: 39937780 DOI: 10.1371/journal.pone.0314045
    In an evolutionary era of medical education, "Artificial intelligence" (AI) is applied to replicate human intellect, encompassing abilities, logical reasoning and effective problem-solving skills. Previous research has explored the attitude of medical and dental students, toward the assimilation of AI in medicine; however, a significant gap exists in appraising the understanding and concerns of pharmacy students. Therefore, the current study was designed to explore undergraduate pharmacy students' perceptions of integrating AI into education and practice.

    METHODS: A cross-sectional study was conducted among final-year pharmacy students from different public and private sector universities in Karachi. The sample size on 60% anticipated response rate and 99% CI was calculated to be 390. Data was collected after acquiring ethical approval using convenient sampling. Frequency and percentage of the socio-demographic features were analyzed and then goodness of fit and Pearson's chi-squared test of correlation was applied. Results were considered significant when p < 0.05.

    RESULTS: The overall response rate of the study was 67%. More than 80% of the respondents were female. The students 35% (n = 202) strongly agreed and 59% (n = 334) agreed that AI plays an important role in healthcare, (χ2 = 505.6, p < 0.001). Around 79% (n = 453, χ2 = 384.3, p < 0.001) of students agreed on the replacement of patient care specialties with AI in the future, whereas 495 students (87%, χ2 = 682.3, p < 0.001) stated that they possess a strong comprehension of the fundamental principles governing the operation of AI. More than 80% of the students were comfortable in using AI terminologies (n = 475, χ2 = 598, p < 0.001) and 93% (n = 529, χ2 = 290, p < 0.001) were sure that AI inclusion in pharmacy education will develop a positive influence into the pharmacy curriculum (95%, n = 549, χ2 = 566.9, p < 0.001). A high and positive correlation was observed between the perception and willingness of students to adopt the AI changes in teaching undergraduate students (ρ = 0.491, p < 0.001). Furthermore, the outcomes showed students at private-sector universities stood out in computer literacy compared to public-sector universities (χ2 = 6.546, p < 0.05).

    CONCLUSION: The current outcomes revealed the higher willingness of pharmacy students towards AI-infused learning. They understood the prerequisite of having both formal and informal learning experiences on the clinical application, technological constraints, and ethical considerations of the AI tools to be successful in this endeavor. The policymakers must take action to ensure that future pharmacists have a strong foundation of AI literacy and take initiatives to foster the interests and abilities of imminent pharmacists who will spearhead innovation in the field.

    MeSH terms: Adult; Artificial Intelligence*; Cross-Sectional Studies; Education, Pharmacy/methods; Female; Humans; Male; Pakistan; Surveys and Questionnaires; Young Adult
  16. Cortese A, Dohrn MF, Curro R, Negri S, Lassuthova P, Pisciotta C, et al.
    Brain, 2025 Feb 13.
    PMID: 39938083 DOI: 10.1093/brain/awaf021
    Biallelic loss-of-function mutations in the sorbitol dehydrogenase (SORD) gene cause the most common recessive type of Charcot-Marie-Tooth disease (CMT), CMT-SORD. However, the full genotype-phenotype spectrum and progression of the disease remain to be defined. Notably, a multicenter phase 2/3 study to test the efficacy of govorestat (NCT05397665), a new aldose reductase inhibitor, is currently ongoing. Diagnosing CMT-SORD will become imperative when disease-modifying therapies become available. In this cross-sectional multicentre study, we identified 144 patients from 126 families, including 99 males (69%) and 45 females (31%). Patients represented multiple ancestries, including European, Hispanic, Chinese, Near Eastern, and Northern African. We confirmed c.757delG (p.Ala253GlnfsTer27) as the most common pathogenic allele, followed by c.458C>A (p.Ala153Asp), while other variants were identified mostly in single cases. The average sorbitol level in CMT-SORD patients was significantly higher compared to controls and heterozygous carriers, independently from serum storage duration, sex, or variant type. Two-thirds of cases were diagnosed with CMT2 while one-third had distal hereditary motor neuropathy (dHMN). Disease onset was usually in the second decade of life. Although foot dorsiflexion was the most affected muscle group, dorsal and plantar flexion had a similar degree of weakness in most cases (difference of Medical Research Council score ≤ 1). One fourth of patients used ankle foot orthoses, usually in their 30s, but most patients maintained independent ambulation later in life. Nerve conduction studies (NCS) were suggestive of a motor predominant axonal neuropathy, with reduced conduction velocities in the intermediate range in one fourth of the cases. Sensory conductions in the upper limbs appeared more frequently affected than in the lower limbs. Foot dorsiflexion and plantar flexion decreased significantly with age. Male sex was significantly associated with the severity of distal lower limb weakness (plantar flexion) and a larger change over time (dorsiflexion). In conclusion, CMT-SORD is a frequent recessive form of axonal, motor predominant CMT, with prominent foot dorsiflexion and plantar flexion involvement. Fasting serum sorbitol is a reliable biomarker of the condition that can be utilized for pathogenicity assessment of identified rare SORD variants.
  17. Kiat J, Ahmad M, Mei Hsien Chan C, Zainalabidin S, Ungar M, Subramaniam P
    JMIR Res Protoc, 2025 Feb 12;14:e56826.
    PMID: 39938084 DOI: 10.2196/56826
    BACKGROUND: The impact of adverse childhood experiences (ACEs) has been the focus of most studies for the past decade. There is an indication that developing resilience can help youth overcome these ACEs.

    OBJECTIVE: This article presents a study protocol for a randomized controlled trial (RCT) to investigate the effects of a resilience-building intervention on psychological well-being, coping strategies, stress, quality of life, resilience, resource finding, and resilience among individuals affected with ACEs in Malaysia.

    METHODS: The is a 2-armed, single-blind, RCT, whereby 50 participants (25 in each group) with ACEs will be randomly assigned to intervention and control groups. The former will be exposed to a resilience-building program (R2), which entails a multisystemic approach to resilience and recognizes the importance of rugged qualities and access to resources among individuals affected with ACEs. The intervention will be delivered via internet-based by a facilitator and broadly divided into 5 sessions, focusing on self-exploration and social support, coping techniques and coping skills, resource finding, spirituality, and resilience building. Meanwhile, the control group participants will not receive any form of intervention. Saliva samples will also be collected from both groups and assessed for salivary cortisol levels. Outcome measures will be assessed during baseline and postintervention using validated instruments. Another follow-up measurement will be conducted 4 weeks later.

    RESULTS: The clinical trial has been registered with the Australia New Zealand Clinical Trials Registry. Ethical approval was obtained from the Research Ethics Board at the National University of Malaysia (UKM PPI/111/8/JEP-2021-894). A total of 28 participants have been recruited to the RCT Participant recruitment will be completed by January 2025. The final analysis will be conducted by March 2025.

    CONCLUSIONS: This is among the first studies to provide evidence in the context of RCTs for resilience-building intervention that combines self-report and physiological measures (ie, saliva and heart blood pressure) among individuals with ACEs. The findings will assist relevant authorities in the health and policy sectors to develop effective strategies for addressing the negative impacts of ACEs on the vulnerable population in Malaysia.

    TRIAL REGISTRATION: ACTRN12622000604707; https://www.anzctr.org.au/Trial/Result/DataSharingStatement.aspx?id=383614.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56826.

    MeSH terms: Adaptation, Psychological*; Adolescent; Adult; Child; Female; Humans; Malaysia; Male; Quality of Life/psychology; Randomized Controlled Trials as Topic; Single-Blind Method; Resilience, Psychological*; Young Adult
  18. Ramli SR, Azhar ZI, Raman S, Yusof SN, Mohamad M
    Cancer Epidemiol, 2025 Feb 11;95:102756.
    PMID: 39938130 DOI: 10.1016/j.canep.2025.102756
    BACKGROUND: Colorectal cancer (CRC) ranks as the second most deadly cancer globally, accounting for nearly 10 % of all cancer-related deaths in 2021. Despite advancements in CRC management, significant disparities in survival rates persist, even in highly developed countries. These lower survival rates are particularly evident in socioeconomically deprived areas and regions with limited healthcare accessibility. Our objective was to assess the impact of individual and geographical variations on CRC survival outcomes.

    METHODS: This retrospective cohort study utilised secondary data from the National Cancer Registry. Adult CRC patients diagnosed between 1st January 2013 to 31st December 2018 (6 years), with documented cause of deaths were included. Kaplan-Meier survival analysis was conducted to determine the 5-year survival rate and median survival time, while multilevel Cox proportional hazard analysis was carried out to identify factors that contribute to the overall CRC survival.

    RESULTS: A total of 18,513 CRC patients were diagnosed between 2013 and 2018, with 10,819 deaths occurred during follow-up. The 5-year CRC survival rate was 42 % with median survival time of 36 months (95 %CI: 34.46-37.54). After adjusting for covariates in multilevel Cox proportional hazard regression analysis, the study found that older age, male gender, Malay and other ethnicities, living in Peninsular Malaysia, rectal, rectosigmoid and anal cancers, advanced disease stage, receiving other, none or delayed treatments, and living in less densely populated areas were significantly associated with a higher risk of mortality (p 

  19. Li Y, Jiang C, Abdul-Rashid SH, Ghazilla RAR, Jin J
    Arch Gerontol Geriatr, 2025 Feb 10;131:105781.
    PMID: 39938241 DOI: 10.1016/j.archger.2025.105781
    This study investigates the influence of smart kitchen appliance design features on older adults' technology acceptance in China using the Smart Kitchen Appliance-Senior Technology Acceptance Model (SKA-STAM). The SKA-STAM extends the Technology Acceptance Model (TAM) with five key design elements: ergonomics, visuals, functions, interactive interfaces, and brands. A cross-sectional survey using a structured questionnaire was administered to 352 Chinese older adults aged 65-84 in first- and second-tier cities from August to October 2024. Participants were recruited through convenience sampling in residential areas, parks, and fitness spaces in Shanghai and Nanjing, and online random sampling in other cities. Structural equation modeling (SEM) was used to analyze the relationships between design elements, older adults' perceptions, and behavioral intention. The results support the significant role of ergonomics, functions, interactive interfaces, and brands in shaping older users' perceived usefulness, ease of use, and enjoyment. Perceived ease of use emerged as a critical mediator linking design elements to usefulness and enjoyment perceptions. The findings contribute to the theoretical understanding of technology acceptance among older adults and provide practical insights for designing senior-friendly smart kitchen appliances.
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