Browse publications by year: 2025

  1. Ismail AI, Hyder Ali IA, Wong CK, Ban AY, Mz Zahrah F, Lem LK, et al.
    Pulm Ther, 2025 Mar;11(1):25-40.
    PMID: 39520649 DOI: 10.1007/s41030-024-00278-8
    INTRODUCTION: The MERIT study in Malaysia is a real-world retrospective, observational, multicenter study that evaluated asthma control in patients with uncontrolled asthma who were switched from as-needed (pro re nata [PRN]) budesonide/formoterol or inhaled corticosteroid (ICS) whenever a short-acting beta-agonist (SABA) was taken, to proactive regular dosing of fluticasone propionate/salmeterol (FP/SAL PRD).

    METHODS: Data from the medical records of patients who were stepped up to FP/SAL PRD were extracted retrospectively at baseline and follow-up (between 3 and 6 months after stepping up to FP/SAL PRD). The primary endpoint was the percentage of patients with improvement in asthma control assessed via the Asthma Control Test (ACT). Secondary endpoints included safety and the percentage of patients with moderate and severe exacerbations. Additionally, patient-reported use of reliever medication, systemic corticosteroids, emergency department visits, or hospitalization was also analyzed.

    RESULTS: One hundred twenty patients with uncontrolled asthma who were stepped up to FP/SAL PRD were enrolled in the study. Of these, 76 (63.3%) patients were on prior budesonide/formoterol PRN, and 44 (36.7%) were on prior ICS with SABA PRN treatment. After stepping up to FP/SAL PRD with a mean follow-up of 5.8 months, 110 (91.7%) patients achieved asthma control at the follow-up visit (p 

  2. Jing H, Chen Y, Liang B, Tian Z, Song F, Chen M, et al.
    Geriatr Nurs, 2025;62(Pt A):272-279.
    PMID: 39521661 DOI: 10.1016/j.gerinurse.2024.10.030
    BACKGROUND: Frailty is considered highly prevalent among the elderly, and falls are a severe adverse event that occurs at a significantly higher rate in frail elderly patients, leading to serious consequences. The pre-frailty stage represents a reversible transitional state between health and frailty, and targeted interventions for pre-frail older adults can effectively reduce the incidence of falls in this population. Existing studies have not definitely identified the risk factors for falls in pre-frail older adults. This paper explores the relevant risk factors for falls in pre-frail older adults.

    METHODS: PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, Wan fang, and VIP databases were searched for studies published from inception to 2023, without language restrictions. Observational studies were included in this systematic review that analyzed risk factors for accidental falls in pre-frail older adults. The NOS scale was used to evaluate the quality of cohort studies and case-control studies, while the AHRQ scale was used to evaluate the quality of the cross-sectional study. We utilized odds ratios (OR) and their corresponding 95 % confidence intervals (CI) to describe the statistical indicators. OR and 95 % CI values were directly extracted and organized in Excel. In cases where OR and CI values were not directly available, we extracted β and p values, calculated Exp using functions, and subsequently derived OR and 95 % CI using formulas. Finally, data pertaining to each risk factor were incorporated into RevMan 5.4 software for statistical analysis and effect size synthesis. We performed tests for heterogeneity and evaluated publication bias.

    RESULTS: A total of 14,370 studies were initially identified, and 26 studies were included in the systematic review. Among these studies, 14 were of high quality, while the remaining 12 were of moderate quality. A total of 16 risk factors were identified as potential risk factors for falls in pre-frail older adults. Significant risk factors were peripheral neuropathy(OR = 3.18, 95 %CI:3.02-3.35), decreased gait speed(OR = 1.90, 95 %CI:1.60-2.27), decreased ability to perform activities of daily living(OR = 1.57, 95 % CI:1.42-1.75), grip strength decreases(OR = 1.53, 95 % CI:1.17-2.00), gender (female)(OR = 1.51, 95 % CI:1.39-1.64), pain(OR = 1.47, 95 %CI:1.41-1.54), history of falls(OR = 1.20, 95 %CI:1.13-1.28) and age(OR = 1.10, 95 %CI:1.07-1.14).

    CONCLUSIONS: The occurrence of falls in pre-frail older adults is associated with multiple risk factors. These risk factors can provide clinical nursing staff with specific focal points for monitoring this population and devising targeted fall prevention measures, with the aim of reducing the incidence of falls in pre-frail older adults.

    REGISTRATION: The systematic review was registered on the International Prospective Register of Systematic Review (CRD42023450670).

    MeSH terms: Aged; Aged, 80 and over; Humans; Risk Factors
  3. Aburub SS, Rahim NY, Mahmoud AM, Maluin FN
    PMID: 39522227 DOI: 10.1016/j.saa.2024.125380
    In this study, mannitol-functionalized magnetic nanoparticles (MMNPs) as a unique nanosorbent and N-doped fluorescent carbon dots (N-CDs) as a cost-effective nanosensor were created and utilized, for the first time, for dispersive micro-solid-phase extraction (Dµ-SPE) to determine carmine (E120) dye in water samples and juices. The modification of the magnetic nanoparticles with mannitol was designed to enhance the responsive potential for adsorption of the polar E120 dye from complex sample matrices through electrostatic interaction. The as-fabricated N-CDs fluorescent probe exhibited a high fluorescence quantum yield (Φs) of 43.1 %, allowing for accurate fluorometric detection of E120 dye. The as-synthesized MMNPs nanosorbent and fluorescent N-CDs nanoprobe were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), energy dispersive X-ray (EDX), thermogravimetric analysis (TGA), and vibrating-sample magnetometer (VSM). Density functional theory (DFT) studied the E120 dye structure using Gaussian 09 to explore the interactions between E 120 dye molecules and MMNPs/N-CDs. The impact of the critical adsorption and detection experimental factors was investigated and adjusted. A minimal amount of MMNPs nanosorbent (150 mg) is sufficient for E120 extraction in an acceptable time of 15 min. Furthermore, with a high determination coefficient, the adsorption characteristics fit with the models of Langmuir isotherm and first-order kinetics. The maximum adsorption capacity (qm) of the as-fabricated MMNPs was 87.7 mg.g-1. After adsorption, E120 dye was fluorometrically analyzed using nitrogen-doped carbon dots as a fluorescent nanosensor via the inner filter effect (IFE) mechanism. Under the optimized conditions, the proposed fluorometric procedures showed a linear increase in the fluorescence ratio with increasing the E120 concentration in the range of 1.0 - 160.0 μg.mL-1 with detection (LOD) and quantitation (LOQ) limits of 0.27 and 0.83 μg.mL-1, respectively. The relative standard deviation (%RSD) did not exceed 2.34 %. The proposed methodology was successfully applied to determine E120 dye in juice and environmental water samples with % recovery ranged from 89.2-106.1 % and 92.9-107.2 %, respectively offering a reliable and environmentally friendly alternative to traditional detection methods with potential applications across various industries.
    MeSH terms: Spectrometry, Fluorescence/methods; Water/chemistry; Limit of Detection; Magnetite Nanoparticles/chemistry
  4. Aloufi KM, Gameraddin M, Alhazmi FH, Almazroui IS, Osman H, Khandaker MU
    Appl Radiat Isot, 2025 Jan;215:111583.
    PMID: 39522393 DOI: 10.1016/j.apradiso.2024.111583
    BACKGROUND: Nuclear medicine diagnostic and treatment procedures represent significant sources of ionizing radiation exposure for both staff and patients. Consequently, assessing and optimizing radiation doses are crucial to minimize potential side effects.

    AIM: This study seeks to evaluate the effective radiation doses associated with common diagnostic and treatment procedures, as well as propose diagnostic reference levels (DRLs), within two nuclear medicine centers in Madinah, Saudi Arabia.

    METHODOLOGY: Data from 445 patients were gathered from two nuclear medicine centers in the Madinah region of Saudi Arabia. The data were categorized based on the type of nuclear medicine (NM) procedure, the chemical composition of the administered radiopharmaceutical, as well as patient age and weight. Effective radiation doses for prevalent NM procedures were computed, and suggested DRLs were formulated.

    RESULTS: Effective radiation doses were analyzed for 16 adult and 2 pediatric NM procedures (divided into 8 groups). The effective radiation doses for adult diagnostic nuclear medicine procedures range from 0.05 mSv (Nanocoloid) to 29 mSv (67Ga-citrate). For pediatric procedures, the doses range from 0.80 mSv (5-year-old undergoing renal DTPA) to 1.6 mSv (1-year-old undergoing renal DMSA). Furthermore, DRL values were determined for both adult and pediatric NM procedures. The study's findings demonstrated a high degree of concordance between effective radiation doses and DRL values, aligning well with previously published research.

    CONCLUSION: While the effective radiation doses outlined in this study were generally within acceptable limits and consistent with prior research findings, optimizing radiation doses remains imperative, particularly for pediatric NM procedures.

    MeSH terms: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Male; Nuclear Medicine*; Radiation Dosage*; Saudi Arabia; Radiopharmaceuticals/analysis; Young Adult
  5. Owen CM, Bacardit J, Tan MP, Saedon NI, Goh CH, Newton JL, et al.
    Exp Physiol, 2025 Feb;110(2):230-247.
    PMID: 39526963 DOI: 10.1113/EP091876
    Gravity, an invisible but constant force , challenges the regulation of blood pressure when transitioning between postures. As physiological reserve diminishes with age, individuals grow more susceptible to such stressors over time, risking inadequate haemodynamic control observed in orthostatic hypotension. This prevalent condition is characterized by drops in blood pressure upon standing; however, the contrary phenomenon of blood pressure rises has recently piqued interest. Expanding on the currently undefined orthostatic hypertension, our study uses continuous non-invasive cardiovascular data to explore the full spectrum of blood pressure profiles and their associated frailty outcomes in community-dwelling older adults. Given the richness of non-invasive beat-to-beat data, artificial intelligence (AI) offers a solution to detect the subtle patterns within it. Applying machine learning to an existing dataset of community-based adults undergoing postural assessment, we identified three distinct clusters (iOHYPO, OHYPO and OHYPER) akin to initial and classic orthostatic hypotension and orthostatic hypertension, respectively. Notably, individuals in our OHYPER cluster exhibited indicators of frailty and sarcopenia, including slower gait speed and impaired balance. In contrast, the iOHYPO cluster, despite transient drops in blood pressure, reported fewer fallers and superior cognitive performance. Surprisingly, those with sustained blood pressure deficits outperformed those with sustained rises, showing greater independence and higher Fried frailty scores. Working towards more refined definitions, our research indicates that AI approaches can yield meaningful blood pressure morphologies from beat-to-beat data. Furthermore, our findings support orthostatic hypertension as a distinct clinical entity, with frailty implications suggesting that it is worthy of further investigation.
    MeSH terms: Machine Learning; Aged; Aged, 80 and over; Artificial Intelligence*; Female; Humans; Male; Posture/physiology; Cluster Analysis
  6. Liow CH, Mohd Esa N, Yaacob A, Abu Saad H
    Clin Nutr ESPEN, 2025 Feb;65:36-42.
    PMID: 39527982 DOI: 10.1016/j.clnesp.2024.11.001
    BACKGROUND & AIMS: Testosterone, vital for reproductive health and muscle development, declines with age, increasing susceptibility to conditions like diabetes, obesity and sarcopenia. Conventional hormone therapy carries risks, including elevated prostate-specific antigens and prostate cancer risk, prompting exploration of safer options like intermittent fasting (IF) and physical training (PT) which potentially boost androgen in certain cases. However, their combined impacts on testosterone remain underexplored. This study aimed to assess the individual and combined effects of IF and PT on androgen and androgen receptor (AR) levels.

    METHODS: Forty male Wistar rats were divided into five groups (n = 8 each): negative control (NC) receiving food ad libitum without orchiectomized, positive control (PC) receiving daily testosterone enanthate injections, IF with 16/8 time-restricted feeding, PT with 1-h forced swimming sessions, and combined IF + PT. After 8 weeks, DHEA and testosterone levels, AR expression, gastrocnemius muscle histology, and body weight were assessed.

    RESULTS: In comparison to the NC group (429.40 ± 26.86 g), body weight in the IF (348.90 ± 15.94 g, PT (391.40 ± 16.35 g), and IF + PT groups, (360.90 ± 29.90 g) was significantly lowered (p 

    MeSH terms: Androgens; Animals; Body Weight; Dehydroepiandrosterone; Fasting; Male; Orchiectomy*; Physical Conditioning, Animal; Swimming*; Rats, Wistar*; Rats
  7. Agarwal S, Prasad S, Agarwal A, Raja Ali RA, Leffler DA, Green PHR, et al.
    J Gastroenterol Hepatol, 2025 Jan;40(1):142-152.
    PMID: 39528309 DOI: 10.1111/jgh.16793
    BACKGROUND AND AIM: Celiac disease (CeD) is increasingly diagnosed but significant disparities exist in awareness, practices, resources, and legislation worldwide. We conducted a global online survey with CeD experts to assess this disparity internationally.

    METHODS: A 55 questions survey encompassing nine domains relevant to CeD care (awareness, gluten-free [GF] foods availability/cost/quality, GF labeling, CeD dietician availability, insurance for CeD patients, medical training, research funding, patient support groups, and unmet needs) was generated and sent to CeD experts worldwide electronically. Countries were stratified based on per capita income as high-income (HIC) and lower-income countries (LIC) (including upper-middle-, lower-middle-, and low-income countries). Survey responses were summarized as a single score using principal component analysis.

    RESULTS: Valid responses were obtained from 131(37.4%) [HIC: 71; LIC: 60] of contacted CeD experts from 63 countries. Compared with HIC, LIC experts perceived worse availability (HIC:80% vs LIC: 47%; P 

    MeSH terms: Developing Countries*; Humans; Income; Surveys and Questionnaires; Global Health; Developed Countries*; Healthcare Disparities/economics; Diet, Gluten-Free/economics
  8. Huang C, Lin J, Chen L, Sun W, Xia J, Wu M
    Mol Neurobiol, 2025 Apr;62(4):5234-5251.
    PMID: 39531193 DOI: 10.1007/s12035-024-04615-5
    The blood-brain barrier (BBB) is a neurovascular structure that safeguards the brain by inhibiting the passage of harmful substances. In individuals with type 2 diabetes mellitus (T2DM), the heightened blood glucose may cause damage to endothelial cells and neurons, increase collagen protein content, and elevate BBB permeability. Although the impact of blood glucose regulation on the structure and function of BBB has been documented, the exact mechanism remains incompletely elucidated. The primary aim of this investigation was to uncover the pivotal dysregulation of specific genes observed within the cerebral microvascular endothelial cells of diabetic patients, with a particular focus on understanding its biological implications in the disruption of the BBB. By integrating bioinformatics analysis, we identified C1QC as a potential upregulated marker. The expression level of C1QC was subsequently verified in both in vivo and in vitro models. Our experiments have discovered that, under diabetic conditions, suppressing C1QC leads to the mitigation of BBB damage. The presence of a high level of C1QC, through its binding to discoidin domain receptor 2 (DDR2), may trigger the activation of its downstream MMP9, a calcium-dependent enzyme that is capable of degrading protein components in the extracellular matrix, consequently leading to the structural and functional disruption of BBB. In summary, the findings of this study indicate that the aberrantly upregulated expression of C1QC may exert deleterious effects on the BBB under diabetes. To alleviate neurological impairments in individuals with T2DM, C1QC may emerge as a promising therapeutic target worthy of further investigation.
    MeSH terms: Animals; Humans; Male; Up-Regulation*; Matrix Metalloproteinase 9/metabolism; Endothelial Cells/metabolism; Endothelial Cells/pathology
  9. Eguchi A, Hassan N, Numata S
    Int J Biometeorol, 2025 Feb;69(2):403-409.
    PMID: 39531205 DOI: 10.1007/s00484-024-02819-x
    The flowering period of durian is influenced by weather conditions such as prolonged drought and low temperatures. However, the specific criteria and durations of these conditions remain unclear. This study aimed to identify weather conditions that trigger durian flowering by monitoring its phenology and analyzing the relationship between minimum temperature and rainfall using two types of durian- grafting type and seed-grown type. Three flowering events were observed in 2022 and two in 2023. Considering there were no differences in the number or timing of flowering events among the two types, it suggests that genetic background differences do not influence flowering phenology. All flowering events were best explained using the 15-day moving average of rainfall, with the peak of the first flowering occurring approximately 50 days after the 15-day moving average of rainfall fell below 1 mm. These results suggest that drought accumulation over approximately 15 days may trigger the induction of durian flower buds. However, no correlation was determined between the minimum temperature and the first flowering date. These findings indicate that durian flowering is induced by milder drought conditions than those previously proposed. Differences in variety and climate may have led to results different from those reported in earlier studies. Long-term monitoring across multiple sites and varieties is required to discuss these differences further.
    MeSH terms: Rain*; Temperature*; Tropical Climate*; Droughts*
  10. Murdiyarso LS, Rajahram GS, Tan AF, Piera KA, William T, Oyong DA, et al.
    Am J Trop Med Hyg, 2025 Jan 08;112(1):85-88.
    PMID: 39531730 DOI: 10.4269/ajtmh.24-0264
    Zoonotic malaria presents a major public health challenge in Southeast Asia. Plasmodium cynomolgi coinfects the same macaque hosts and mosquito vectors as the most common cause of zoonotic malaria, Plasmodium knowlesi. Plasmodium cynomolgi appears morphologically similar to Plasmodium vivax on microscopy and can amplify P. vivax polymerase chain reaction (PCR) assays, confounding transmission estimates. We screened 2,103 samples for P. cynomolgi across all 26 districts in Sabah, Malaysia, from 2010 to 2021. Samples comprised 1,425 P. knowlesi, 256 P. vivax, 293 P. falciparum, and 31 Plasmodium malariae PCR-confirmed malaria cases and 100 malaria microscopy-positive and species-specific PCR-negative samples. A nested PCR assay targeting P. cynomolgi-specific 18S small subunit ribosomal ribonucleic acid with a detection limit of ∼2 parasites/µL was conducted on whole blood samples. No P. cynomolgi infections were detected. Symptomatic P. cynomolgi co-infections appear rare in Malaysia, although prevalence may be underestimated owing to the absence of routine molecular screening and the sensitivity of available assays.
    MeSH terms: Animals; Humans; Malaysia/epidemiology; Microscopy*; RNA, Ribosomal, 18S/genetics; Zoonoses/diagnosis; Zoonoses/epidemiology; Zoonoses/parasitology; Prevalence; Polymerase Chain Reaction; Plasmodium knowlesi/genetics; Plasmodium knowlesi/isolation & purification; Coinfection/diagnosis; Coinfection/epidemiology; Coinfection/parasitology
  11. Tin Ern N, Komarasamy TV, Adnan NAA, Balasubramaniam VRMT
    Am J Trop Med Hyg, 2025 Jan 08;112(1):37-44.
    PMID: 39531732 DOI: 10.4269/ajtmh.23-0545
    Flavivirus infection, especially dengue virus infection caused by DENV, is known to be a significant health concern globally owing to the high incidence and mortality rate. The expanding and increasing disease burden calls for the need to develop an effective treatment and prevent the event of fatal complications, including dengue hemorrhagic fever/dengue shock syndrome. The DENV-induced immune response has been described as paradoxical because it has a protective role in viral clearance but, at the same time, causes more severe infection through viral-specific immunity. This is further complicated by high homology and cross-reactivity between different serotypes of DENV, causing a more severe disease presentation during secondary infection by a heterologous serotype. This serotype complexity poses a challenge for the development of a universal flavivirus vaccine. This review highlights the significance of high motility group box 1 (HMGB1) and nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing 3 (NLRP3) inflammasome activation pathways in initiating an inflammatory response through the downstream activation of nuclear factor κB and proinflammatory cytokine Interleukin (IL)-1B, IL-18 release in DENV infection. It also discusses the role of NLRP3 in activating cellular apoptosis and pyroptosis leading to systemic failure, especially in peripheral tissues. Over the decades, there has been much progress in understanding the immunopathogenesis of DENV infection. Researchers have been studying key pathogenic molecules for potential therapeutic targets including HMGB1 and NLRP3 inflammasome inhibitors, which is explored in this review. Ultimately, although there is not yet an effective antiviral or vaccine for DENV, immunomodulators continue to pave the way to decrease disease severity in infected individuals.
    MeSH terms: Animals; Antiviral Agents/therapeutic use; Humans; HMGB1 Protein/immunology
  12. Wong YP, Tan GC, Khong TY
    APMIS, 2025 Jan;133(1):e13496.
    PMID: 39509086 DOI: 10.1111/apm.13496
    The 2016 Amsterdam Placental Workshop Group Consensus Statement recommends sampling a block of the placenta close to the umbilical cord insertion site (UCIB) for histopathological evaluation. This piece of placenta at the umbilical cord insertion is presumed to give a better yield of inflammation (if present). We aimed to investigate the utility of the UCIB in the detection of maternal and/or fetal inflammatory responses (MIR and/or FIR), in comparison with the other sections of the placental parenchyma. This is a retrospective cross-sectional study including all placentas with histologic chorioamnionitis. The histopathological slides of placentas were reviewed as per Amsterdam consensus guidelines. Diagnostic performance of UCIB in identifying MIR and/or FIR, relative to the other placental sections, was assessed. UCIB revealed diagnostic sensitivity, specificity, and diagnostic accuracy of 79.2% (95% CI: 74.2-83.6%), 100.0% (95% CI: 95.6-100.0%), and 83.6% (95% CI: 79.5-87.2%), respectively, in the detection of FIR, while showing a low sensitivity of 52.6% (95% CI: 47.5-57.6%) in detecting MIR. In 59 (24.6%) cases, FIR was not seen in the corresponding placental parenchymal sections but was detected in the UCIBs. This study is the first study to confirm that a section from the UCIB is essential for the detection of FIR, which affirms the Amsterdam consensus sampling recommendations.
    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Inflammation/diagnosis; Inflammation/pathology; Pregnancy; Retrospective Studies; Sensitivity and Specificity; Young Adult
  13. Salleh NS, Abdullah KL, Chow HY
    J Pediatr (Rio J), 2025;101(2):133-149.
    PMID: 39510130 DOI: 10.1016/j.jped.2024.07.012
    OBJECTIVE: There is a pressing need for public health practitioners to understand cultural values influencing parents on the uptake of human papillomavirus (HPV) vaccination for their daughters, which is presenting a growing challenge to close the immunization gap worldwide. Parental decisions were predominantly shaped by cultural norms and values. This systematic review encompasses parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters.

    METHOD: This systematic review was registered on PROSPERO CRD42020211324. Eligible articles were selected from CINAHL, PsycINFO, EMBASE, PubMed and Science Direct. Original qualitative studies exploring parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters under the age of 18, published in the English language with no restriction dates were reviewed. Two authors independently screened abstracts, conducted the fill-text review, extracted information using a standardized form, and assessed study quality. A third author is needed to resolve the disagreements if necessary.

    RESULTS: Of the 1552 citations, 22 were included, with information on 639 parents. Five themes emerged from the data: sexuality-related concerns; upbringing and moral values; obligation to protect; external influences; and vaccine-related concerns.

    CONCLUSION: This systematic review is beneficial to identify and understand the culturally related facilitators and barriers to HPV vaccination among young women for the development of strategies to optimize HPV vaccine coverage among this population group by the policymakers.

    MeSH terms: Adolescent; Child; Cultural Characteristics; Female; Humans; Health Knowledge, Attitudes, Practice; Nuclear Family; Patient Acceptance of Health Care/psychology; Vaccination/psychology
  14. Bellato A, Parlatini V, Groom MJ, Hall CL, Hollis C, Simonoff E, et al.
    J Child Psychol Psychiatry, 2025 Feb;66(2):266-270.
    PMID: 39513414 DOI: 10.1111/jcpp.14071
    Individuals with attention-deficit/hyperactivity disorder (ADHD) exhibit varied responses to pharmacological treatments (e.g. stimulants and non-stimulants). Accurately and promptly detecting treatment-related improvements, response failure, or deterioration poses significant challenges, as current monitoring primarily relies on subjective ratings. In this commentary, we critically evaluate the evidence supporting the use of QbTest for objectively monitoring ADHD treatment response in clinical practice. We also offer recommendations for future research, advocating for rigorous clinical trials and longitudinal studies to further explore the potential utilisation of QbTest and other tools for monitoring treatment responses in individuals with ADHD.
    MeSH terms: Central Nervous System Stimulants/pharmacology; Central Nervous System Stimulants/therapeutic use; Child; Humans; Outcome Assessment (Health Care)/standards
  15. Kong ST, Lim SH, Ching J, Ho PC
    J Pharm Biomed Anal, 2025 Jan 15;253:116561.
    PMID: 39514984 DOI: 10.1016/j.jpba.2024.116561
    This study compared the effectiveness of capillary dried blood spots (DBS) versus venous DBS in detecting metabolic changes related to drug-resistant epilepsy (DRE). DBS samples were collected from 142 epilepsy patients (58 drug-resistant, 84 drug-responsive) via venipuncture or fingerstick capillary sampling. Metabolomic analysis using gas chromatography-mass spectrometry compared DBS metabolite profiles between the two groups. While venous DBS profiles showed no distinct patterns, capillary DBS profiles revealed clustering patterns in principal components analysis, with the first two principal components explaining 14.5 %, and 13.5 % of the total variance, respectively. Orthogonal PLS-DA confirmed group discrimination (R2Y=0.989, Q2=0.742). Drug-resistant patients exhibited elevated capillary DBS levels of glutamine, pyruvic acid, and serine, and decreased palmitic acid compared to drug-responsive patients. Pathway analysis revealed disruptions in amino acid metabolism, neurotransmission, and cellular energy regulation. Elevated glutamine levels may contribute to an imbalance between excitatory glutamate and inhibitory GABA neurotransmission, key factors in epileptogenesis and drug resistance. Capillary DBS, likely enriched with arterial blood supply to the brain, appears to better capture central nervous system metabolic disturbances compared to venous DBS containing systemic contributions. This minimally invasive capillary DBS approach offers effective metabolic profiling of brain conditions like DRE, for monitoring disease progression and treatment response, enhancing personalized patient management in epilepsy.
    MeSH terms: Adolescent; Adult; Capillaries/metabolism; Child; Female; Humans; Male; Middle Aged; Veins/metabolism; Young Adult
  16. Tanpowpong P, Treepongkaruna S, Huang JG, Chew KS, Mercado KSC, Reodica A, et al.
    Clin Exp Pediatr, 2025 Mar;68(3):247-256.
    PMID: 39533716 DOI: 10.3345/cep.2024.01144
    BACKGROUND: Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited.

    PURPOSE: Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children.

    METHODS: The multinational network included patients with PIBD (aged <19 years) in 5 Asian countries (Malaysia, Philippines, Singapore, Sri Lanka, and Thailand). The diagnosis of PIBD requires gastrointestinal endoscopy. The patients' demographics, clinical information, disease- related outcomes, and treatment data at 1FU were collected.

    RESULTS: In 1995-2021, 368 patients were enrolled (Crohn disease [CD], 56.8%; ulcerative colitis [UC], 38%; and inflammatory bowel disease [IBD]-unclassified, 5.2%). At 1FU, symptoms including diarrhea, bloody stools, and nausea/vomiting subsided in <3%, while abdominal pain persisted in 10.5% of patients with CD and 7.1% of patients with UC. Assessment endoscopy was performed at 1FU in 38% of CD and 31% of UC cases, of which 21% and 23% showed mucosal healing, respectively. Oral prednisolone was administered to 55.3% of patients at diagnosis and 26.8% at 1FU, while infliximab was administered to 2.5% and 7.2% of patients at diagnosis and 1FU, respectively. Independent factors of 1-year clinical remission for CD were oral prednisolone (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06-0.68), antibiotic use (OR, 0.09; 95% CI, 0.01-0.54), and immunomodulator use (OR, 5.26; 95% CI, 1.52-18.22). A history of weight loss at diagnosis was the only independent risk factor of an IBD flare by 1FU (OR, 2.01; 95% CI, 1.12-3.63).

    CONCLUSION: The proportion of children with PIBD and abdominal pain at 1FU remained high. The rates of repeat endoscopy and infliximab use were suboptimal with high rates of systemic corticosteroid use. Quality improvement based on the aforementioned predictors may enhance PIBD care in this geographic region or similar settings.

  17. Chua KY, Chua KY, Chinna K, Lim CL, Seneviwickrama M
    Clin Exp Pediatr, 2025 Feb;68(2):115-126.
    PMID: 39533723 DOI: 10.3345/cep.2024.00899
    The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systematic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged <18 years. Systematic searches were conducted in October 2023 and repeated in March 2024 of the PubMed, Scopus, and Web of Science databases. The grey literature was also included. Study selection, data extraction, and quality assessments were conducted by paired independent researchers. A metaanalysis of prevalence and 95% confidence interval (CI) using a random-effects model and heterogeneity (I2) was calculated. Publication bias was investigated using Egger's test. This review included 33 studies (N=273,710) conducted between 1996 and 2022. Overall, the childhood overweight, obesity and excess weight prevalence was 13.9% (95% CI, 13.0%-14.8%), 11.8% (95% CI, 10.9%-12.8%), and 24.0% (95% CI, 22.3%-25.7%), respectively. Boys had a significantly higher proportion of obesity (12.5% [95% CI, 11.1%-14.1%] vs. 9.1% [95% CI, 8.1%-10.1%]) and excess weight (25.7% [95% CI, 23.5%-28.1%] vs. 20.7% [95% CI, 18.8%-22.8%]) than girls. Sarawak natives had a higher prevalence of obesity (17.7% [95% CI, 16.0%-19.5%]). Annually, the obesity prevalence increased by 0.3% (95% CI, 0.1%-0.6%; P=0.006) and excess weight prevalence increased by 0.6% (95% CI, 0.3%-1.0%; P=0.002). Heterogeneity was high (I2>90%), and publication bias was possible (P<0.001). Variability was not significantly affected by the critical appraisal score or sample size. In conclusion, the prevalence of childhood overweight, obesity, and excess weight in Malaysia doubled over 26 years. Future studies of the prevalence of childhood excess weight should follow a standardized reference for body mass index by age to ease interstudy comparisons.
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