SIGNIFICANCE: Proteins are mostly degraded during preparation and loading into nano-carriers which hinders success in protein delivery.
METHOD: Herein, novel PEC consisting of model protein BSA and nanogels (NGs), were prepared to form self-assembled polyelectrolyte nanocomplexes (BSA/NGs-PEC). The BSA/NGs-PEC were obtained by mixing BSA and nanogels at various weight ratios (1:2, 1:4, 1:5, 1:6, 1:8, 1:10), pH values of solution (1.2, 4.0, 6.0), incubation time (2, 4, 6, 8 h), and stirring rate (without, 100, 200 rpm). The prepared PEC were evaluated for particle size (PS), polydispersity index (PDI), zeta potential (ZP), and percentage of complexation efficiency (%CE). To study insights into structural integrity and biological activity, the SDS-PAGE and esterase activity assay was performed on BSA released from final optimized formulation.
RESULTS: The optimized parameters were BSA/nanogels mixing ratios at 1:8, pH of complex-forming medium at 4.0, incubation time of 6 h, and stirring rate at 100 rpm. The SDS-PAGE and esterase activity assay revealed that the primary structure and bioactivity, respectively, of BSA was still intact.
CONCLUSION: The results suggest that current scheme for optimization has considerable potential for creating protein-based delivery system by using PEC via electrostatic interaction.
METHODS: This study utilized cancer data reported to the Sarawak State Health Department with a cancer notification form. Data was obtained from the State cancer database. Incidence, Age-Standardized Rate, frequency, cumulative rate, and lifetime risk were calculated. The population included Sarawak residents only who were defined as Malaysian citizens as well as permanent residents living in Sarawak at the time of diagnosis.
RESULTS: Between years 2011-2015, there were a total of 10,320 cancer cases (47.3% male). The incidence rate was approximately 16.6 persons per 100,000 population per year. An increasing trend was observed in cancer incidence with increasing age. Ethnic distribution reported the highest incidence among the Chinese (male cases:36.2% and female cases:36.4%), followed by the Iban (male cases:26.9% and female cases:24.5%), and Malay (male cases:18.3% and female cases:22.0%). The three most common cancers in male were colorectal (15.4%), nasopharyngeal (14.8%), and trachea, bronchus, lung (14.0%) cancer. In females, the first three common cancers were breast (27.9%), cervix uteri (11.6%), and colorectal (9.8%). There were wide disparities among common cancers across genders, different age groups and ethnic groups.
CONCLUSION: The lifetime risk of a Sarawakian to develop cancer by age 75 is 1 in 11 in females and 1 in 10 in males. This present study provided a framework for the status and trend of cancer in Sarawak. These findings will provide additional information to guide strategy and resource planning in improving cancer care in Sarawak.
METHOD: This case-control study was conducted at Aziz Fatimah Hospital and Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan, from May 2023 to January 2024. A total of 170 subjects were included in the study through purposive sampling technique. Fasting and random blood glucose levels were measured using an enzymatic colorimetric test. HbA1c was determined with the Bioherms A1C EZ 2.0 Glyco-hemoglobin Test Kit. QOL was assessed using the Short Form-36 version 1 questionnaire. Statistical analysis was performed using SPSS version 26, with p ≤ 0.05 considered significant.
RESULTS: The study included 86 T2DM patients and 84 controls, with a mean age of 49.23 ± 12.59 years. Among the participants, 44.7% were male and 55.3% were female. T2DM patients scored lower in physical functioning, limitations due to physical health, bodily pain and vitality subscale compared to controls (p = 0.003, 0.050, 0.030, 0.000 respectively). Both groups had physical component summary and mental component summary (MCS) scores below 50, indicating impaired QOL. MCS scores were significantly lower in T2DM patients than in controls (p = 0.002). Females scored lower in vitality (p = 0.0005) and bodily pain (p = 0.031). T2DM patients with less than five years of duration had lower SF-36 scores than those with longer duration.
CONCLUSION: T2DM impairs quality of life, especially in females and those with less than five years of disease duration, who face a greater negative impact.
METHODS: Six congenital CVD subjects volunteered to participate in this study. Ishihara plates were used to determine the colour vision errors made, whereas Farnsworth-Munsell 100 Hue test was conducted to determine the total error scores (TES) and type of CVD. Four types of RCL (Types A, B, C and D) were inserted in the non-dominant eye and tested in a randomised manner by a masked operator. Errors scores in Ishihara test were determined at baseline without any contact lens and after wearing the four different RCL. The subjects were then divided into two groups based on the mean TES.
RESULTS: Repeated measures ANOVA with Greenhouse-Geisser corrections showed that there was a highly significant effect of RCL type on Ishihara error score [F(2.056, 10.282)=30.214, P<0.001]. Error scores with RCL Type B were significantly lower than errors made when no lens was worn, and with RCL Type C and Type D (all P<0.001). Error scores with RCL Type B were also lower than those made with RCL Type A, however, they were not significantly different. For subjects with TES values less than 180, RCL type B showed the largest improvement in Ishihara error score (50%) compared to the other three RCLs. RCL type A showed the best performance in TES value of more than 180, with an improvement of 80% in Ishihara score. RCL Type A has the lowest transmittance at the confusion wavelength (450-568 nm), followed by RCL Types B, D and C.
CONCLUSION: This study shows that RCL can improve Ishihara error scores. RCL with lower transmission at 450-568 nm and 90% transmittance beyond 637 nm are the most effective. Lenses which could block more light between 550-580 nm are more effective for colour defectives with more severe colour defects.
METHODS: We derived the data from the Malaysian National Health and Morbidity Survey 2017: Adolescents Health Survey (NHMS 2017: AHS). We examined the association between SHS exposure and depression in 24497 secondary school students. Descriptive and multivariable logistic regression analyses were performed.
RESULTS: The study revealed that 42% of the students were exposed to SHS during the last seven days. Depression symptoms were associated with SHS exposure (AOR=1.16; 95% CI: 1.07-1.25) after adjusting for possible confounding effects of other independent variables, including age, gender, ethnicity, smoking status of respondents, marital status of parents, physically being bullied, and physical and verbal abuse.
CONCLUSIONS: To prevent and control school-going adolescents' exposure to SHS, health education and smoking cessation among those who have close contact with adolescents should be enhanced. In addition, promoting more smoke-free areas, including houses and public places, should be intensified among secondary school students in Malaysia as they transition to adulthood.
METHODS: This was a retrospective cohort study that utilized data extracted from records of children aged 1 month to 15 years who were diagnosed with malaria and admitted to Al Sabah Children's Hospital, Juba, South Sudan from 1 January to 31 December 2021. Kaplan-Meier was employed to estimate the survival functions, and the log-rank test statistic was used to compare survival curves with respect to categories of specific covariates.
RESULTS: Out of 6,410 children diagnosed with malaria who were included in this study, 3,595 (56.08%) were males and 2815 (43.92%) were females. A total of 303 (4.73%) died and 6,107 (95.27%) were censored. The median survival time was three days (IQR 2-4), and the mean age of the study cohort was 23.66 months (95% CI: 23.01 to 24.32). Comorbidity status among children indicated that 1,552 (24.01%) had comorbidities during admission. With respect to the treatment covariate, 3,920 (61.15%) were treated with artesunate. Kaplan-Meier survival curves showed increased survival for children treated with quinine and those without comorbidity. The log-rank test revealed that the covariates treatment and comorbidity were significant (p < 0.05), both having an impact on survival among children.
CONCLUSION: This study found that the median survival time for children with malaria was three days. Additionally, comorbidity decreased survival among children. Treatment with quinine showed better survival rates compared to artesunate, despite studies suggesting artesunate as a replacement for quinine. Strengthening the healthcare system, provision of good-quality drugs, and implementing control intervention measures to reduce the transmission of malaria are essential for improving child survival in the country. Furthermore, it is essential to carry out a comparative study of quinine and artesunate for the treatment of malaria. Future studies on malaria in South Sudan have to be conducted by using a prospective study design to address the challenges of incomplete data and potential biases.
METHODS: The RNA expression profiles and corresponding clinical data of HCC were retrieved from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and International Cancer Genome Consortium (ICGC). Univariate Cox regression analysis was performed to identify the relevant prognostic genes, and Lasso Cox regression analysis was employed to calculate the risk score. The relationship between the risk score and clinicopathological characteristics, immune cell infiltration, and immune checkpoint expression was analyzed.
RESULTS: A prognostic risk model for HCC was constructed from the identified CDRGs and patients were subgrouped based on risk score. High-risk patients for HCC exhibited a significantly lower overall survival (OS) rate than the low-risk patients. In addition, the receiver operating characteristic (ROC) curve demonstrated the predictive ability of the risk score. Patients in the high-risk group exhibited lower immune cell infiltration and higher expression levels of immune checkpoint molecules.
CONCLUSIONS: The cell death-related signature established herein provides a valuable predictive tool for survival and holds promise as a potential therapeutic biomarker for HCC.
METHODS: A cross-sectional survey using questionnaires was conducted among the representatives of ASEAN countries from October 2023 to March 2024.
RESULTS: Neurology training programs are available in 9 of the 11 ASEAN countries except Timor Leste and Cambodia. Despite the growing number of neurologists, with a doubling of the neurologist-to-patient ratio in most countries in the past 2 decades, the neurologist density per 100,000 population remained low. Thailand, Singapore, and Brunei Darussalam have more than 1 neurologist per 100,000 population compared with 2007 when only Singapore and Brunei Darussalam had more than this ratio. In Cambodia, Lao People's Democratic Republic (PDR), Myanmar, and Timur Leste, although the number of neurologists has increased substantially, the ratio of neurologists remains low, with less than 1 in a million population in Myanmar, 1:625,000 population in Lao PDR, 1:526,000 population in Cambodia, and 1:430,000 in Timur Leste. The total duration of training from undergraduate to certified neurologist varies greatly because of compulsory internal medicine (IM) training and postinternship services. To enroll in neurology training, candidates in 4 countries (Brunei, Singapore, Malaysia, and Myanmar) must have completed IM as a prerequisite. Candidates from Thailand and Indonesia must fulfill their 2-year compulsory government or general practice service requirement before they are eligible for neurology training. After fulfilling the eligibility criteria to enter neurology training, the overall training duration ranges from 3 to 13 years. Malaysia and Myanmar are countries where candidates spend more than 10 years becoming certified neurologists.
DISCUSSION: The number of neurologists and the neurologist-to-patient ratio have improved since 2007 in ASEAN countries. Diverse neurology curricula and the variable duration to complete neurology training and subspecialty practice are the main challenges in improving neurology training in ASEAN countries.
METHODS: Using the Malaysian National Cardiovascular Disease-Acute Coronary Syndrome (NCVD-ACS) registry, DAPT 5-year temporal trends prescribing patterns at discharge were examined. Multivariate logistic regression was used to calculate the adjusted odds ratio (aOR) of DAPT prescription. The 1-year all-cause mortality by Cox proportional hazard regression model (adjusted hazard ratio, aHR) using inverse proportional weighting covariates adjustment was performed to assess DAPT prognostic impacts.
RESULTS: Data of patients aged 60 years and older were extracted from 2013 to 2017 (n = 3718, mean age: 68 ± 6.74 years, men: 72%, and Malay ethnicity: 43%). The majority of patients were diagnosed with non-ST-segment elevation acute coronary syndrome (63%), predisposed hypertension (76%) and were overweight (74%), while only 35% of patients underwent percutaneous coronary intervention. Over the five years, there was a significant increasing trend in DAPT prescriptions (P < 0.001), with the aspirin-clopidogrel combination being the most common. Aspirin-ticagrelor prescriptions have also increased over the years. Variations in DAPT prescriptions were observed based on patient characteristics. Patients who underwent percutaneous coronary intervention were more likely to be prescribed DAPT in general (aOR = 2.53, 95% CI: 1.95-3.28, P < 0.001) and aspirin-ticagrelor specifically (aOR = 7.76, 95% CI: 5.65-10.68, P < 0.001). Patients with chronic lung disease (aOR = 0.62, 95% CI: 0.42-0.92, P = 0.02) and a history of angina within two weeks (aOR = 0.69, 95% CI: 0.56-0.85, P < 0.001) were approximately 30% less likely to be prescribed DAPT. Approximately 15% of 1-year all-cause mortality were reported. Older patients prescribed DAPT showed significantly higher survival rates than those who were not (aHR < 1.0, P < 0.001). Aspirin-ticagrelor was associated with higher survival rates than aspirin-clopidogrel (aHR = 0.21, 95% CI: 0.11-0.40, P < 0.001).
CONCLUSIONS: Despite the optimal prescription rate and variation of DAPT in the older Malaysian population, there is room for investigation and improvement in the prescription of newer DAPT combinations that have been suggested to improve patient survival.
METHODS: Retrospective data were obtained from medical records of all children born between 2008 and 2011 who were diagnosed with clinical or confirmed autism. One-way ANOVAs and regression analyses were used to analyze data.
RESULTS: Data from 2577 medical records were extracted. There were more boys (82.5%) and ethnic group distribution was Chinese (67%), Malay (14%), Indian (10%), and Others (10%). Chinese children were more likely to present at a developmental clinic with concerns 3-4 months younger compared to Malay children and those from Other Races (F(3, 2038) = 9.58, p
OBJECTIVES: This research aims to understand if personal and career burnout can affect employers' acoustic environment evaluation of their workplace.
METHOD: Considering commonly experienced or highly experienced personal and career burnout among working women, the study targeted female university faculty members. The research involved stratified sampling and employed data from 272 individuals across five public and private universities in Tehran. Collected data were analyzed using SmartPLS (latest release 4.1).
RESULTS: The results revealed a significant link between personal and career burnout and the subjective evaluation of workplace acoustic environment. Career burnout mediated the relationship between personal burnout and negative evaluation of the workplace acoustic environment.
CONCLUSION: This study provides compelling evidence that experiences of burnout, whether related to personal or career aspects, substantially impact the subjective assessment of the acoustic environment within the workplace. The results underscore the complex interplay between an individual's degree of burnout and their subjective perception of the acoustic dimensions of their work environment. The findings extend our understanding of how psychological factors might shape our interpretation of the physical workplace.
AIM: Establishing an animal model that reproduces migraine-like action is important in medical research to identify the mechanism underlying this disorder. Additionally, it facilitates the availability and reliability of new models that may act as human surrogate models.
METHOD: Rabbits were divided into four groups. Negative group, migraine group, rizatriptan-nitroglycerin group, and rizatriptan group. The frequency of head scratching and the histopathological changes in the brain, liver, kidney, and heart for groups were evaluated in all groups.
RESULTS: The behavioral characteristic of head scratching was significantly increased in the NTG group (50.4 ± 3.8) compared with the control group (9.2 ± 1.3) after 30 min of the experiment. Moreover, animals treated with rizatriptan benzoate (Riza) 10 mg/kg/orally for 14 days followed by NTG injection showed a significant decrease in the head scratch action (16.8 ± 2.3 and 17.6 ± 3.3) than the animals of NTG group (50.4 ± 3.8 and 43.6 ± 2.3) after 30 min and 60 min, respectively. Furthermore, animals treated with Riza alone showed no statistical differences in the head scratches (7.8 ± 1.3, 9.2 ± 0.8, 10.6 ± 1.1 and 9.6 ± 1.3, respectively) during the 120 min of the experiment, compared with the control group. Histopathological alterations in the brain of rabbits that received NTG showed severe diffuse dilated and engorged blood vessels. These changes were also recorded in the liver and kidney of this group. This marked vasodilation of blood vessels and central and portal veins confirms the successful induction of migraine in the rabbit model. In contrast, animals treated with Riza for 14 days demonstrated substantially less vascular dilation following NTG injection. No significant pathological lesions were observed in animals treated with Riza.
CONCLUSION: The current study successfully established a rabbit model of migraine using a single dose of NTG to induce migraine-like behavior. Moreover, pre-treatment with rizatriptan benzoate for fourteen days significantly reduced the symptoms of migraine and histopathological changes in different organs.
METHODS: A convenience sampling method was used to conduct a questionnaire survey among 628 nurses from five hospitals in Liaoning Province in March 2021 and June 2021 using a combination of online and offline methods. To study the negative attitudes toward patients with mental illness among clinical nurses and to analyze the relationship between mental ill health stigma, social distancing, and mental health knowledge among nurses. The questionnaire includes Sociodemographic data, Scale for Assessing the Stigma of Mental Illness in Nursing (score range: 20~100, the higher the score, the less stigma attached to mental ill health), Mental Illness Social Distance Scale (score range: 6~30, the higher the score, the greater the social distance) and Mental Health and Mental Health Knowledge Questionnaire (score range: 0~25, the higher the score, the higher the knowledge level).
RESULTS: The nurses' mental ill health stigma score was 58.96 ± 9.38 points, the mean scores of psychiatric and general nurses were 58.86 ± 9.33 and 59.41 ± 9.58 points, respectively. Willingness to become a psychiatric nurse is a factor influencing the stigma of mental illness. The stigma of mental ill health, social distance and mental health knowledge of nurses are positively correlated (P<0.01). The mediation analysis demonstrated that mental health stigma significantly mediated the relationship between mental health knowledge and social distance (a= 0.599, P<0.001; b= -0.194, P<0.001). After accounting for stigma, the direct effect of mental health knowledge on social distance was no longer significant (c'=-0.007, P=0.078), highlighting the central role of stigma in this relationship.
CONCLUSIONS: Nurses mental ill health stigma is moderate and is the main mediating effect between mental health knowledge and social distancing. The pivotal role of mental health knowledge in shaping nurses' attitudes and behaviors pertaining to social distancing in the context of mental illness. By combating stigma and enhancing mental health literacy among healthcare practitioners, we can foster environments that promote inclusive and compassionate care practices, thereby ameliorating patient outcomes and redressing disparities in mental health treatment.