MATERIALS & METHODS: The Schiff base ligand was synthesized by refluxing isatin and thiosemicarbazide for 3 hours. Complexes 2 and 3 were formed and characterized using elemental analysis, molar conductivity, IR, NMR, and UV-Visible spectroscopy. The geometry of complex 3 was determined via X-ray diffraction. Theoretical calculations were conducted using DFT with the hybrid GEN B3LYP method. Molecular docking was performed to assess binding energies with EGFR, and anticancer activity was evaluated against the A549 cell line.
RESULTS: Characterization confirmed successful synthesis of the compounds. Zinc complexation led to notable spectral shifts, and X-ray diffraction revealed complex 3 adopted a distorted tetrahedral geometry. DFT analysis highlighted complex 2 with the lowest energy gap (0.331 eV). Docking results showed strong EGFR binding energies (-5.70, -5.54, and -7.30 kcal/mol). Complex 2 demonstrated the highest anticancer efficacy with a cell viability of 1.35% after 48 h.
CONCLUSIONS: Complex 2 exhibits significant anticancer potential and warrants further investigation as a therapeutic agent.
METHODS: This qualitative study used a phenomenological research design and was conducted from January to December 2022, involving 47 adolescents aged 10 to 17 years old from 37 PPRs in the Klang Valley. Participants were recruited using the purposive sampling method as this study purposely selected adolescents with moderate, moderately severe, and severe for PHQ-9 and/or moderate and severe for GAD-7 based on the screening. Participants who agreed to participate were recruited (with consent from parents/guardians) and interviews were set at the participants' convenience. Data were collected using a semi-structured interview guide to conduct the in-depth interviews (IDI). After each IDI session, the recorded interviews were transcribed. Data from the voice recorder were stored on a password-protected computer, and participants' names were replaced with specific codes to ensure confidentiality. The researchers coded all transcripts independently. The transcripts were analysed inductively using a thematic approach to identify recurring themes.
RESULTS: From the 37 PPRs, 194 adolescents were identified as having psychological distress based on the screening. Among them, 47 agreed to participate in the IDIs, which revealed that these adolescents utilized mainly maladaptive coping strategies, such as avoidance (cognitive distancing, externalization, and internalization), self-harm, vaping, and smoking to deal with stressors related to COVID-19. As for hindrances to help-seeking, three themes were identified such as lack of trust, perceived ineffectiveness of support, and personality.
CONCLUSION: Psychological distress among adolescents was prevalent during the pandemic, and they faced hindrances in seeking help. Coping strategies have been identified to help adolescents manage their psychological distress during the pandemic. It is concerning that some had resorted to maladaptive coping mechanisms. These findings emphasized the need for targeted mental health interventions and support systems tailored to vulnerable communities. These interventions could inform policies aimed at strengthening mental health services, fostering better coping strategies and promoting help-seeking behaviours among adolescents in socio-economically challenged communities.
OBJECTIVES: This study was conducted to investigate the perception and understanding of pre-clinical and clinical educators on what clinical reasoning entails, their experience, and educational strategies in teaching clinical reasoning.
METHOD: A semi-structured interview was conducted with fifteen educators encompassing pre-clinical (basic science, laboratory-based) and clinical (surgical-based, medical-based, community-based and emergency medicine) educators. The transcribed interview data was then analysed thematically.
RESULTS: Eight main themes were identified. Knowledge and experience were seen as important components in developing clinical reasoning. It was possible to teach clinical reasoning although there were some difficulties thus the need to have a train-the-trainer programme. Early introduction of clinical reasoning with its incorporation in various teaching and learning method; and the involvement of technological advances were also mentioned by the participants. However, pre-clinical educators did not perceive the importance of these technological advances. Role of educators; cognitive and non-cognitive attributes were also important in developing clinical reasoning.
CONCLUSION: The perception and understanding of pre-clinical and clinical educators on clinical reasoning did not really differ. They believed that clinical reasoning can be taught, and a train-the-trainer program may be of immeasurable benefit.
OBSERVATIONS: The challenges in addressing the cardiovascular disease burden in Asia include unique cardiometabolic features of the different populations, heterogeneity of risk factors among Asian countries, differing levels of health literacy and socioeconomic status, suboptimal infrastructure to support preventive care especially in the primary care sector, high out-of-pocket costs, and environmental pollution.
CONCLUSIONS: Asia is a large continent that comprises diverse populations with varying cultures, socioeconomic status, and health literacy levels. Effective preventive cardiology may require differential health care resource allocation and financing models.
METHODS: ELISA-based assay was developed to detect IgG and IgM antibodies against SARS-CoV-2. The assay was examined in serum and urine samples of two different cohort of patients affected by COVID-19 disease with different severity and compared to age and sex matched control group. Neutralizing antibody activity was evaluated using an RBD-ACE2 binding inhibition assay. Additionally, a Sengenics protein microarray platform was employed to assess epitope-specific antibody responses.
RESULTS: The in-house ELISA assay reliably detected antibodies in both 163 serum and 64 urine samples compared to 50 serum samples from healthy control, with strong correlations observed between antibody levels in the two biofluids. Neutralizing antibody levels correlated positively with disease severity, highlighting their clinical relevance. The performance of the in-house assays was comparable to commercial kits, and the Sengenics microarray provided detailed insights into antibody profiles, identifying dominant epitopes within the Nucleocapsid core domain and RBD.
CONCLUSIONS: The developed in-house assay demonstrated robust performance and versatility, offering a cost-effective and scalable alternative to commercial kits. Their ability to detect antibodies in both serum and urine highlighted their potential as non-invasive diagnostic tools. These findings contribute to advancing sero-diagnostic capabilities, improving understanding of immune responses to SARS-CoV-2, and supporting global efforts to monitor and manage COVID-19 effectively.
METHODS: Patients were randomized 1:1 to cemiplimab 350 mg intravenous every 3 weeks for 2 years or investigator's choice of chemotherapy. The primary endpoints were overall survival (OS) and progression-free survival (PFS).
RESULTS: A total of 712 patients were randomized to cemiplimab (n = 357) or chemotherapy (n = 355). Median duration of follow-up was 59.6 months (interquartile range: 55.1-66.7 months) at the data cutoff (January 16, 2024). In patients with verified PD-L1 ≥50% (n = 565), median OS was 26.1 months for cemiplimab vs. 13.3 months for chemotherapy (hazard ratio [HR] 0.59, 95% confidence interval [CI]: 0.48-0.72); median PFS was 8.1 months versus 5.3 months (HR 0.50, 95% CI: 0.41-0.61); the objective response rate was 46.5% versus 20.6%. The 5-year OS probability was 29.0% for cemiplimab and 15.0% for chemotherapy. Improved survival outcomes were observed with both squamous and non-squamous histology, and increasing activity of cemiplimab was correlated with higher PD-L1 expression, with the highest PD-L1 expression having the best outcome. The safety profile remains consistent with previous results. Grade ≥3 treatment-related adverse events occurred in 18.3% of patients for cemiplimab and 39.9% for chemotherapy.
CONCLUSIONS: At 5-year follow-up, first-line cemiplimab monotherapy continued to show durable clinical benefits versus chemotherapy in patients with advanced NSCLC with PD-L1 ≥50%. Patients with PD-L1 ≥90% derived the largest clinical benefits.