Browse publications by year: 2025

  1. Awomuti A, Yu Z, Adesina O, Samuel OW, Mumbi AW, Yin D
    SAR QSAR Environ Res, 2025 Feb;36(2):145-167.
    PMID: 40126364 DOI: 10.1080/1062936X.2025.2478123
    Peroxisome proliferator-activated receptor gamma (PPARγ), a critical nuclear receptor, plays a pivotal role in regulating metabolic and inflammatory processes. However, various environmental contaminants can disrupt PPARγ function, leading to adverse health effects. This study introduces a novel approach to predict the inhibitory activity (IC50 values) of 140 chemical compounds across 13 categories, including pesticides, organochlorines, dioxins, detergents, flame retardants, and preservatives, on PPARγ. The predictive model, based on the light-gradient boosting machine (LightGBM) algorithm, was trained on a dataset of 1804 molecules showed r2 values of 0.82 and 0.59, Mean Absolute Error (MAE) of 0.38 and 0.58, and Root Mean Square Error (RMSE) of 0.54 and 0.76 for the training and test sets, respectively. This study provides novel insights into the interactions between emerging contaminants and PPARγ, highlighting the potential hazards and risks these chemicals may pose to public health and the environment. The ability to predict PPARγ inhibition by these hazardous contaminants demonstrates the value of this approach in guiding enhanced environmental toxicology research and risk assessment.
    MeSH terms: Algorithms; Pesticides/toxicity; Pesticides/chemistry; Inhibitory Concentration 50; Quantitative Structure-Activity Relationship*
  2. Albaharna H, Alrasheed A, AlQahtani A, Psaltis AJ, Javer A, Meco C, et al.
    PMID: 40126454 DOI: 10.1002/alr.23572
    BACKGROUND: Advancements in endoscopic sinus and skull base surgery created a need for standardized terminology to describe sphenoid sinus surgery. Although classification systems exist for other sinuses, one for endoscopic sphenoid sinus surgery is lacking. Developing such a system would standardize procedure descriptions and promote a common language among surgeons. This study aimed to develop a new classification system for endoscopic sphenoid surgery.

    METHODS: Consensus on a novel endoscopic sphenoid surgery classification system by running the Delphi procedure with 16 rhinology experts from around the world.

    RESULTS: Four Delphi rounds were required to reach a consensus on all stages of the classification. The average percentage of agreement on the stages of classification progressively increased from 70.83% in the first round to 87.68% in the last round. The rejection rates continuously decreased from 8.81% in the first round to 4.44% in the last round. The classification system was developed as follows: stage 1, presphenoid surgery; stage 2A, partial sphenoidotomy; stage 2B, complete sphenoidotomy; stage 2C, transpterygoid sphenoidotomy; stage 3A, Rostral sphenoidectomy; and stage 3B, extended sphenoid drill-out.

    CONCLUSIONS: This novel endoscopic sphenoid surgery classification system facilitates the description of different sphenoid sinus procedures, providing surgeons with better opportunities for discussion and communication.

  3. Tan SH, Yap YY, Tan SK, Wong CK
    JMIR Aging, 2025 Mar 24;8:e60936.
    PMID: 40126531 DOI: 10.2196/60936
    BACKGROUND: The aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concerns. Despite being a substantial user group in traditional health services, older adults may encounter barriers to adopting telehealth services. Increasing the adoption of telehealth among the older adult population is crucial for enhancing their access to care and managing the challenges of aging effectively.

    OBJECTIVE: We aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs.

    METHODS: A cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable.

    RESULTS: Of the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; P

    MeSH terms: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Patient Acceptance of Health Care/psychology; Patient Acceptance of Health Care/statistics & numerical data; Surveys and Questionnaires
  4. Dedouit F, Ducloyer M, Elifritz J, Adolphi NL, Yi-Li GW, Decker S, et al.
    Int J Legal Med, 2025 Mar 24.
    PMID: 40126650 DOI: 10.1007/s00414-025-03461-x
    Over the last few decades, forensic imaging has become an essential part of current forensic practice. The aim of this 4-part review is to provide a comprehensive overview of forensic imaging over the first 25 years of this century. After a brief historic review, this first part details the advantages and limitations of post-mortem imaging for the indications most frequently encountered in daily practice.
  5. Lam NFD, Cai J, Ng KH
    Phys Eng Sci Med, 2025 Mar 24.
    PMID: 40126762 DOI: 10.1007/s13246-025-01535-z
    Current clinical practice in imaging medical physics is concerned with quality assurance, image processing and analysis, radiation dosimetry, risk assessment and radiation protection, and in-house training and research. Physicist workloads are projected to increase as medical imaging technologies become more sophisticated. Artificial intelligence (AI) is a rising technology with potential to assist medical physicists in their work. Exploration of AI integration into imaging medical physicist workloads is limited. In this review paper, we provide an overview of AI techniques, outline their potential usage in imaging medical physics, and discuss the limitations and challenges to clinical adoption of AI technologies.
  6. Chin HW, Jamil A, Muhamad Sarkan M, Tang JJ
    Photodermatol Photoimmunol Photomed, 2025 Mar;41(2):e70015.
    PMID: 40126791 DOI: 10.1111/phpp.70015
    INTRODUCTION: Vitiligo is a depigmenting autoimmune disease. This study aimed to determine the minimal erythema dose (MED) of vitiligo-affected skin and normal skin among patients with skin phototype III, IV, and V.

    METHODS: A cross-sectional study was performed. MED was determined using a handheld device with wavelength of 311 nm. Vitiligo severity was measured using the Vitiligo Area Scoring Index (VASI) while disease activity was assessed by the Vitiligo Disease Activity (VIDA). Sun exposure was quantified by the Sun Exposure Index (SEI).

    RESULTS: A total of 36 patients (mean age of 49.06 ± 21.29 years old) participated with 12 patients from each skin phototype. MEDs of skin affected by vitiligo were 255 ± 120.3, 280 ± 93.4, and 525 ± 226.1 mJ/cm2 for phototypes III, IV, and V respectively. The MEDs of unaffected skin were 465 ± 120.3, 580 ± 123.6, and 1150 ± 116.8 mJ/cm2 for phototypes III, IV, and V respectively. The MEDs for skin affected by vitiligo were 45%, 52%, and 54% less than the MEDs of unaffected skin for phototypes III, IV, and V respectively. The differences in MEDs between vitiligo-affected skin and unaffected skin were significant for all skin phototypes (p 

    MeSH terms: Adult; Aged; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Skin/metabolism; Skin/pathology; Skin Pigmentation
  7. Seow SR, Mat S, Lam OHH, Maktar JF, Rajab NF, Ismail IS, et al.
    J Vis Exp, 2025 Mar 07.
    PMID: 40127005 DOI: 10.3791/67521
    This study explores hyperglycemia's influence on knee osteoarthritis (KOA) related symptoms, physical performance, physical activity level, radiographic severity, and inflammation in older adults. Prolonged hyperglycemic states contribute to advanced glycation end-product (AGE) formation, which worsens KOA symptoms. Capillary blood glucose (CBG) and glycated hemoglobin A1C (HbA1C) levels are commonly used in laboratory tests for glycemic assessment, offering distinct advantages and limitations. Participants were divided into good and poor glycemic control groups based on their CBG and HbA1C levels. KOA clinical severity and physical activity were measured using the knee injury and osteoarthritis outcome score (KOOS) and international physical activity questionnaire. Physical performance was measured with hand grip strength, gait speed, time-up-and-go (TUG), and 5 times sit-to-stand (5STST). Knee X-rays were performed, and serum enzyme-linked immunosorbent assay (ELISA) analysis was conducted for IL-1β, IL-4, CRP, NF-κB, and AGE. Three hundred recruited participants (mean age [SD] = 66.40 years (5.938) with CBG, of fasting blood sugar > 7.0 mmol/L and random blood sugar > 11.1 mmol/L, (N = 254) were compared with KOOS pain (p=0.008) and symptoms (p=0.017) and 5STST (p=0.015); while HbA1c > 6.3% (N = 93) was compared with 5STST (p=0.002), and AGEs (p=0.022) based on Mann Whitney U test. Logistic regression revealed significant associations between glycemic control and lower limb muscle strength, radiological severity, laboratory markers, and between glycemic status and KOOS pain and symptoms. However, these associations did not remain significant after adjusting for BMI. Poor glycemic status alone was associated with better function in sport and recreation domains after antidiabetic medication adjustment, suggesting anti-inflammatory and analgesic effects that masked the effect of high blood sugar. Future studies could explore the predictive ability of glycemic assessment for poor knee function and physical performance while accounting for the effects of the medication.
    MeSH terms: Aged; Diabetes Mellitus/blood; Female; Hemoglobin A, Glycosylated/analysis; Humans; Inflammation/blood; Male; Middle Aged; Biomarkers/blood
  8. Jalaludin MY, Kiau HB, Hasim S, Lee WK, Low A, Kazim NHN, et al.
    JMIR Pediatr Parent, 2025 Mar 24;8:e58586.
    PMID: 40127457 DOI: 10.2196/58586
    BACKGROUND: Anemia remains a significant public health concern with adverse effects among children. Noninvasive screening assessments enable the early detection and prompt treatment of anemia. However, there is limited literature on the use of such screening assessments.

    OBJECTIVE: The study aimed to assess the prevalence of and factors associated with being at risk of anemia among Malaysian children aged ≥6 months to ≤36 months by using a noninvasive hemoglobin assessment.

    METHODS: This was a cross-sectional study (from July to December 2022) of outpatient Malaysian children, aged ≥6 months to ≤36 months, who were selected from five maternal-and-child health clinics by convenience sampling. At risk of anemia was defined as a total hemoglobin level of <12 g/dL, measured using the Masimo Rad-67, a noninvasive screening device for total hemoglobin levels. The χ2 and multiple logistic regression analyses were used to assess the prevalence and factors associated with being at risk of anemia, using R-Studio (version 4.0.0).

    RESULTS: The study included 1201 participants, of whom 30% (95% CI 28-33) were at risk of anemia. Children aged 6-12 months (210/364, 57.7%, P12-36 months. However, weight-for-age (adjusted odds ratio=0.88; 95% CI 0.80-0.98) was associated with lower odds of being at risk of anemia.

    CONCLUSIONS: The current study revealed a substantial prevalence of Malaysian children being at risk of developing anemia. The study results therefore imply a need for more community education and awareness on anemia, including nutrition education, as well as targeted community screening to enable the early detection and prompt treatment of anemia cases. Anemia reduction strategies in Malaysia should consider the highlighted factors indicative of higher risk of anemia.

  9. Pfuhl G, Prazeres F, Kowal M, Aavik T, Abad-Villaverde B, Afhami R, et al.
    Public Health, 2025 Mar 23;242:220-227.
    PMID: 40127606 DOI: 10.1016/j.puhe.2025.02.030
    OBJECTIVES: Infectious diseases are often associated with decline in quality of life. The aim of this study is to analyze the relationship between personal history of communicable, i.e., infectious and parasitic diseases and self-rated health.

    STUDY DESIGN: Secondary analysis of a large dataset multi-country observational study.

    METHODS: We used a four-pronged analysis approach to investigate whether personal history of infectious and parasitic diseases is related to self-reported health, measured with a single item.

    RESULTS: Three of the four analyses found a small positive effect on self-reported health among those reporting a history of pathogen exposure. The meta-analysis found no support but large heterogeneity that was not reduced by two classifications of countries.

    CONCLUSION: Personal history of infectious and parasitic diseases does not reduce self-reported health across a global sample.

  10. Lim NYY, Chiam SL, Leo CP, Pung SY, Chang CK, Ang WL
    Int J Biol Macromol, 2025 Mar 22;308(Pt 1):142421.
    PMID: 40127804 DOI: 10.1016/j.ijbiomac.2025.142421
    Photocatalysts have been extensively developed as they can degrade various water pollutants under light irradiation without chemical consumption. However, photocatalyst reusability and uniform light distribution still limit the scaling up of photocatalytic processes. This study investigated the photoelectrocatalytic (PEC) system removal of dye using zinc oxide nanorods (ZnONRs) and bismuth oxychloride (BiOCl) immobilized in the carboxymethyl cellulose (CMC) coating containing microfibrillated cellulose (MFC). The photocatalytic properties were significantly enhanced by the presence of MFC with 3D fibrous network that could disperse the photocatalyst, reduce recombination, and promote charge migration. The MFC/ZnONRs/BiOCl/CMC coating worked as a photoanode, which removed 78 % of methylene blue (MB) dye within 60 min under UV light irradiation and a low voltage of 2.5 V.
  11. Grande SW, Epperly M, Tan KY, Yagnik S, Ellenbogen M, Pederson J, et al.
    Ann Fam Med, 2025 Mar 24;23(2):117-126.
    PMID: 40127970 DOI: 10.1370/afm.240165
    PURPOSE: We aimed to address fears and lived experiences of cognitive decline among adults via whole-person conversations that elicit problems and goals that matter most to patients. Currently, 6.7 million Americans have Alzheimer disease or related dementias, with an additional 28 million people reporting subjective cognitive decline-a possible indicator of Alzheimer disease and related dementias. A review of tools for older adults with cognitive impairment showed strong clinical specificity, with insufficient whole-person support for patients. We developed and tested the feasibility and acceptability of a tool to enhance conversations for adults with cognitive impairment at the point of care.

    METHODS: We conducted a feasibility study to build a conversation tool, guided by principles of shared decision making, called the "About Me" Care Card. Informed by an environmental scan, we created and pilot-tested prototypes at implementation sites. All phases were overseen by a multidisciplinary steering committee.

    RESULTS: Fourteen diverse clinicians consisting of 7 clinician types across 7 institutions piloted the card during in-person visits or by telephone. Observations showed that the card (1) allowed time to elicit what matters most to patients, (2) created space for personalized care conversations, (3) opened an examination of social care needs, and (4) moderated emotional relationships between families and individuals.

    CONCLUSION: A community-based codesign process led to a feasible tool for primary care teams to facilitate whole-person conversations with aging adults. The About Me Care Card appeared to broaden conversations compared with routine care. More work is needed to determine scalability and effects on outcomes.

    MeSH terms: Aged; Communication*; Feasibility Studies*; Female; Humans; Male; Physician-Patient Relations; Pilot Projects
  12. Sathiaseelan A, Song KP, Tan HS, Choo WS
    FEMS Microbiol Lett, 2025 Jan 10;372.
    PMID: 40128011 DOI: 10.1093/femsle/fnaf035
    This study investigated the antibiofilm effects of Clitoria ternatea flowers anthocyanin fraction (AF) on Streptococcus mutans, Actinomyces viscosus, and Aggregatibacter actinomycetemcomitans. AF was obtained using column chromatography, and liquid chromatography-mass spectrometry was employed for its characterization and identification. The crystal violet assay and scanning electron microscopy analysis revealed significant inhibition of early biofilm formation and destruction of preformed biofilms after AF treatment (0.94-15 mg ml-1). Antiadhesion assay on acrylic teeth demonstrated that AF effectively hampered sucrose dependent and independent attachment. Importantly, growth curve and pH drop assays showed that AF inhibited pH reduction for all bacteria tested without hindering bacterial growth. Furthermore, the tetrazolium-based cytotoxicity assay indicated no toxicity towards normal human gingival fibroblasts at 0.78-12.5 mg ml-1. These findings suggest C. ternatea anthocyanins are promising antibiofilm agents for oral biofilm control, acting during both initial formation and on mature biofilms.
    MeSH terms: Bacterial Adhesion/drug effects; Fibroblasts/drug effects; Humans; Flowers/chemistry
  13. Tomeh A, Yusof Khan AHK, Abu Zaid Z, Ling KH, Inche Mat LN, Basri H, et al.
    Medicine (Baltimore), 2025 Mar 21;104(12):e41947.
    PMID: 40128024 DOI: 10.1097/MD.0000000000041947
    Collaboration among health and non-health professionals is growing exponentially as we approach the personalized medicine era, where the intervention plan is tailored according to the patient's needs. This collaboration aims to develop highly efficient, patient-centered, holistic approaches, rather than singular interventions. Interdisciplinary rehabilitation is a rising theme to coordinate the efforts of various professionals, with the ultimate goal of increasing rehabilitants' satisfaction and improving their overall quality of life. A typical rehabilitation team may comprise a rehabilitation physician, rehabilitation nurse, occupational therapist, physiotherapist, speech and language therapist, clinical psychologist, social worker, prosthetist, orthotist, rehabilitation engineer, and dietician. The need for inclusion of additional professions in the rehabilitation team is dynamic and varies depending on the population and health condition. Recently, various countries have begun incorporating interdisciplinary rehabilitation models into their healthcare frameworks. For example, the U.S. Veterans Affairs Polytrauma Rehabilitation Centers have set a precedent for integrating interdisciplinary approaches into neurological rehabilitation, while European nations such as Germany and Sweden have successfully implemented stroke and pain rehabilitation programs. Although interdisciplinary rehabilitation has demonstrated effectiveness in improving patient outcomes, further research is required to explore its long-term benefits, cost-effectiveness, and adaptability in resource-limited settings. In this mini-review, we summarize the current evidence on employing interdisciplinary rehabilitation in patients with neurological disorders and highlight the implications for future research and clinical practice.
    MeSH terms: Neurological Rehabilitation/methods; Humans; Quality of Life
  14. Ong RYL, Thazhakkattu Vasu D, Jun LK, Yuet NJ, Isaac Fernandez M, Selvakumar K, et al.
    Medicine (Baltimore), 2025 Mar 21;104(12):e41905.
    PMID: 40128063 DOI: 10.1097/MD.0000000000041905
    BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that leads to impaired lumbopelvic stability, gait dysfunction, and associated pain and psychological distress. This study evaluates the effectiveness of dynamic neuromuscular stabilization (DNS) in improving lumbopelvic stability and gait in AIS patients, comparing it to core stability exercises (CSE). This study evaluates the effectiveness of DNS in improving lumbopelvic stability and gait in AIS patients, comparing it to CSE.

    METHODS: This randomized controlled trial involved participants aged 18 to 25 years with mild to moderate idiopathic scoliosis, who were randomly assigned to either the control or experimental group. Both groups received 12 sessions of supervised exercises over 6 weeks, with the experimental group also incorporating DNS exercises alongside CSE. Lumbopelvic stability was assessed using the single leg squat, while core stability was evaluated with the stabilizer pressure Biofeedback in combination with the Sahrmann core stability test. Additionally, gait spatiotemporal parameters and pelvic dynamics were analyzed using the BTS-G-WALK system.

    RESULTS: Of 30 participants, 28 completed the study, comprising 12 males and 16 females, with 26 having mild right-sided thoracic scoliosis. Both groups showed improvement in the left single leg squat, with the control group reaching 93.3% "Good" performance and the experimental group achieving 69.2%. Gait analysis showed a significant reduction in duration for both groups, with the control group improving from 112.98 to 71.41 seconds (P = .005) and the experimental group improving from 112.33 to 67.68 seconds (P = .021).

    CONCLUSION: This ongoing 12-week study shows that the combined DNS and CSE approach significantly improves lumbopelvic stability in individuals with idiopathic scoliosis. However, the impact on gait parameters was minimal, possibly due to the short duration of the intervention and the similar walking strategies of those with single-curve scoliosis and healthy individuals. These findings highlight the potential of integrating DNS into scoliosis rehabilitation and underscore the need for further research to optimize treatment duration and assess long-term functional outcomes.

    MeSH terms: Adolescent; Adult; Postural Balance/physiology; Female; Humans; Lumbosacral Region; Male; Pelvis*; Treatment Outcome; Young Adult
  15. Mahawar K, Rattan P, Jalamneh A, Ab Yajid MS, Abdeljaber O, Kumar R, et al.
    Sci Rep, 2025 Mar 24;15(1):10172.
    PMID: 40128279 DOI: 10.1038/s41598-025-94642-6
    Higher education is essential because it exposes students to a variety of areas. The academic performance of IT students is crucial and might fail if it isn't documented to identify the features influencing them, as well as their strengths and shortcomings. The student academic prediction system needs to be enhanced so that teachers can forecast their students' performance. Numerous studies have been conducted to increase the prediction accuracy of IT students, but they encountered difficulties with unbalanced data and algorithm tuning. To address these issues, the study proposed different machine learning (ML) algorithms that handled imbalanced data by applying the synthetic minority oversampling technique (SMOTE) and employing hyperparameter tuning algorithms to enhance prediction during the training process. The ML models we used were decision tree (DT), k-nearest neighbor, and XGBoost. The models were fine-tuned by applying Ant colony optimization (ACO) and artificial bee colony optimization techniques. Subsequently, these optimization techniques further enhanced the performance of the models. After comparing them, the results showed that SMOTE and ACO combined with the DT model outperformed other models for academic prediction. Additionally, the study utilized the Kendall Tau correlation coefficient technique to analyze the correlation between features and identify factors that positively or negatively impact student success.
    MeSH terms: Cognitive Neuroscience/methods; Machine Learning*; Algorithms*; Animals; Ants/physiology; Bees/physiology; Decision Trees; Humans; Students
  16. Dedouit F, Ducloyer M, Elifritz J, Adolphi NL, Yi-Li GW, Decker S, et al.
    Int J Legal Med, 2025 Mar 25.
    PMID: 40128331 DOI: 10.1007/s00414-025-03465-7
    The last few decades have seen the emergence of forensic imaging, both clinical and post-mortem. Year after year, the scientific community has refined the radiological tools that can be used for post-mortem and clinical forensic purposes. As a result, scientific societies have published recommendations that are essential for the daily work of forensic imaging. This third part of the review of the current state of forensic imaging describes these recommended radiological tools and also presents an overview of the various international guidelines dealing with post mortem imaging that can be found in the literature or that have been written by scientific societies.
  17. Almuaythir S, Zaini MSI, Hasan M, Hoque MI
    Sci Rep, 2025 Mar 25;15(1):10186.
    PMID: 40128353 DOI: 10.1038/s41598-025-94980-5
    This study investigates the effectiveness of using various agricultural waste ashes-namely eggshell ash (ESA), clamshell ash (CSA), cockle shell ash (CKSA), and oyster shell ash (OSA)-for the stabilization of expansive clay soils (ECS). Laboratory experiments assessed the impacts of these ashes on the soil's consistency limits, shrink-swell behavior, compaction properties, unconfined compressive strength (UCS), shear strength, and mineralogical and microstructural characteristics. The results demonstrated that the inclusion of agricultural waste ashes significantly improved the ECS properties by reducing plasticity from 29.6 up to 7.84%, increasing shrinkage limit from 15.55 to 33.06%, reducing free sweeling index from 57 to 39.66%, and enhancing UCS and shear strength from 114.64 to 1509.95 kPa. Microstructural analysis revealed the formation of cementitious compounds that contributed to a denser and more robust soil structure. This research highlights the potential of these waste materials in sustainable soil stabilization, supporting environmental conservation and infrastructure resilience while aligning with Sustainable Development Goals (SDGs).
  18. Tay LX, Ong SC, Ong HM, Teh EE, Ch'ng ASH, Tiong IK, et al.
    Sci Rep, 2025 Mar 24;15(1):10067.
    PMID: 40128538 DOI: 10.1038/s41598-025-95210-8
    Alzheimer's disease (AD) not only impacts the patients but substantially informal caregivers in terms of physical and psychological burden. This study aims to determine the burden level of informal caregivers of patients with different stages of AD and use of special accommodation (SpA) along with its predictors. A cross-sectional study was conducted by interviewing AD patients and informal caregivers recruited from 4 tertiary hospitals. Zarit Burden Interview (ZBI) was used to estimate caregivers' burden. The analysis categorized informal caregivers of AD patients into two groups based on the use of SpA. Multivariable linear regression was employed to identify potential determinants of subjective caregiver burden. As a result, caregivers' burden experienced by informal caregivers of severe community-dwelling AD patients was significantly higher (p = 0.024) than those with special accommodation. As AD advanced, caregivers' burden was elevated significantly (p = 0.021) from mild to severe AD among community-dwelling patients. In multivariable analysis, severe AD (standardised β = 0.187, p = 0.047 vs. mild AD) and spousal relationship (standardised β = 0.241, p = 0.026 vs. other relationships) were found to be significant factors in predicting caregivers' burden. Hence, the physical and social needs of informal caregivers must not be overlooked. Severe AD significantly increased caregiver burden in community dwelling patients. Spousal caregivers report a higher perceived burden compared to caregivers with other relationships. Policymakers need to recognize and address the substantial demands placed on informal caregivers by providing essential social support. Special accommodation could alleviate the burden on informal caregivers, particularly those caring for patients with severe AD.
    MeSH terms: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Cost of Illness
  19. Yang HY, Ayob KA, Jeong HW, Seon JK
    Sci Rep, 2025 Mar 24;15(1):10099.
    PMID: 40128548 DOI: 10.1038/s41598-025-93542-z
    Assessment of lower limb coronal plane alignment is crucial in surgical planning of total knee arthroplasty (TKA) and is commonly performed with full-length weight-bearing radiographs (FLWBR). The aim of this study was to determine discrepancies in coronal limb alignment as assessed by conventional FLWBR versus non-weight-bearing computed tomography (CT) modalities in robotic arm-assisted TKA. We retrospectively analyzed 100 consecutive patients with osteoarthritic knees who underwent robotic arm-assisted TKA with preoperative FLWBR and CT assessments of knee alignment. The mechanical axes of the Mako system were established in accordance with the Mako TKA Surgical Guide. The following parameters were compared between the two imaging modalities: (1) mechanical hip-knee-ankle angle (mHKA), (2) medial proximal tibial angle (MPTA), (3) lateral distal femoral angle (LDFA), (4) arithmetic hip-knee-ankle angle (aHKA), (5) joint line obliquity (JLO), and (6) proportion of the Coronal Plane Alignment of the Knee (CPAK) types. Regression analyses were performed to identify potential factors associated with discrepancies in measurements of coronal alignment between these two imaging modalities. There were significant differences in terms of the mHKA between preoperative CT and FLWBR (CT vs. FLWBR, 7.0° vs. 8.5°; p 
    MeSH terms: Aged; Aged, 80 and over; Female; Humans; Knee Joint/surgery; Male; Middle Aged; Retrospective Studies; Weight-Bearing*; Osteoarthritis, Knee/surgery
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