Browse publications by year: 2025

  1. Kow CS, Ramachandram DS, Hasan SS, Thiruchelvam K
    J Hypertens, 2025 Apr 01;43(4):719-720.
    PMID: 39995225 DOI: 10.1097/HJH.0000000000003945
  2. Fatima S, Hong WH, Mohd Noor MN, Foong CC, Pallath V
    Teach Learn Med, 2025 Feb 24.
    PMID: 39995249 DOI: 10.1080/10401334.2025.2468953
    Self-regulated learning (SRL) can significantly improve academic achievement and clinical performance. The clinical clerkship is a crucial setting for reinforcing and extending SRL skills and behaviors into clinical practice. However, learning in clinical settings is often opportunistic and contextual, requiring diverse instructional strategies and tailored learning opportunities. Studies from the past two decades have indicated challenges in implementing SRL strategies particularly in Asian countries. While many of the pedagogical approaches used in medical education include aspects of SRL theory, a comprehensive overview of effective SRL instructional strategies in clinical clerkships is lacking. We reviewed all studies (published between January 2012 and May 2024, identified via systematic search of EBSCOhost, PubMed, ScienceDirect, Scopus, and Web of Science) that discuss instructional strategies influencing SRL among clinical clerkship students, in general, and with special reference to the Asian context. Twenty seven articles were included in the final analysis. We conducted convergent integrated synthesis on the data extracted from all included studies to generate categories and themes. SRL instructional strategies reported included implementing learning plans and goal setting, operationalizing formal mentoring and feedback processes, utilizing technology-enhanced learning, facilitating collaborative group learning, providing simulation-based learning experiences, and applying experiential learning strategies. When implemented effectively, such strategies were shown to promote self-regulated learning, motivational beliefs, self-monitoring, and self-reflection. Faculty support, mentoring and timely feedback were crucial in successfully implementing SRL strategies. Incorporating SRL into existing curricula was ideal for ensuring feasibility and long-term sustainability. Limited research from the Asian region indicates that SRL has not been used to its full potential in Asian medical education. Asian medical students' SRL potential could be maximized with shared roles of students and teachers in a student-driven approach. Medical educators should take responsibility for providing opportunities and a conducive environment to foster SRL among clinical clerkship students. Future research should prioritize longitudinal, experimental studies with comparison groups and objective SRL outcome measures to rigorously evaluate the impact of instructional strategies in the clinical clerkship context.
  3. Chen CL, Tang BC, Chen SC, Wen CK, Chen YH, Nor Hairin AL
    ChemSusChem, 2025 Feb 25.
    PMID: 39995384 DOI: 10.1002/cssc.202402690
    β-Zn4Sb3 is a promising thermoelectric material due to its environmental friendliness and suitability for mid-temperature applications which aligns with the development of renewable energy. However, maintaining its pure β-phase during fabrication remains a significant challenge, as phase instabilities often degrade its thermoelectric performance. Here, we demonstrate the successful optimization of β-Zn4Sb3 thin films through controlled Sn doping using ion beam-assisted deposition. By precisely regulating the Sn concentration at 0.97 %, the β-Zn4Sb3 phase is preserved, resulting in a maximum power factor of 1.4 mW m-1 K-2 at 573 K-a 60 % improvement over undoped films. Comprehensive analyses reveal that dilute Sn doping enhances carrier mobility and structural stability while avoiding detrimental phase transitions to ZnSb. These findings highlight the importance of precise doping and processing control in stabilizing the β-phase structure. This work provides a new pathway for fabricating high-quality thermoelectric thin films, offering valuable insights into the development of scalable, efficient energy harvesting technologies.
  4. Al-Herz W, Azizieh F, Raghupathy R
    World Allergy Organ J, 2025 Feb;18(2):101031.
    PMID: 39995506 DOI: 10.1016/j.waojou.2025.101031
    INTRODUCTION: The role of different nutrients in allergic sensitization is not clear. In this study we aimed to determine the effect of high protein (HP) diet on allergic sensitization, cytokine profile, and asthma in mice.

    METHODS: Seven- to eight-week old female BALB/c mice were fed either normal (ND) or HP diet and were sensitized with ovalbumin intraperitoneally followed by intranasal challenge. Allergic sensitization was tested by measuring anti-ovalbumin (OVA) IgE, IgG1, and IgG2a antibodies. Cytokine levels were tested by multiplex ELISA in splenocyte supernatants after stimulation. Airway inflammation was tested by measuring total and differential cell counts in bronchoalveolar lavage fluid and by measuring bronchial mucus production, goblet cell hyperplasia and perivascular and peribronchial inflammation severity scores by histologic examination.

    RESULTS: Mice fed HP diet had a significant increase in weight and higher levels of OVA-specific IgE and IgG1 antibodies compared to the ND group (P-values 0.002, 0.007 and <0.001, respectively). In addition, they showed a selective Th2 bias in cultured splenocyte supernatants compared to the ND group as demonstrated by higher IL-4 and IL-6 levels (P-values <0.001 and 0.011, respectively) and higher ratios of Th2 to Th1 cytokines. However, the level of airway inflammation was comparable between both groups.

    CONCLUSIONS: HP diet increases the risk of allergic sensitization though increase in Th2 cytokines. Efforts should be made to define the upper limit of protein in the diet that does not predispose to allergic sensitization. The effect of diet on health should remain a focus of research for the establishment of optimal health and resilience.

  5. Ma L, Zhao Z
    Heliyon, 2025 Feb 15;11(3):e42427.
    PMID: 39995907 DOI: 10.1016/j.heliyon.2025.e42427
    This study explores the relationship between reading motivation and reading comprehension achievement among English major students in China, an area that has received limited attention in existing literature. Drawing on previous research emphasizing the importance of reading motivation in improving reading skills, this study seeks to examine the connection between reading motivation and reading comprehension achievement within the specific research context. The Pearson correlation coefficient showed a significant positive correlation between reading motivation and reading proficiency among English major students at a Chinese private undergraduate university. The study also indicated that reading motivation can predict reading comprehension scores. This investigation not only fills a gap in current research but also paves the way for future experimental studies to investigate the efficacy of specific motivational interventions or instructional strategies in boosting reading motivation and subsequently improving reading skills among English language learners. The findings of this study are expected to guide educational practices and policies, ultimately leading to advancements in English language education for Chinese students majoring in English.
  6. Osman AA, Chin SF, Teh LK, Abdullah N, Abdul Murad NA, Jamal R
    Heliyon, 2025 Feb 15;11(3):e42197.
    PMID: 39995923 DOI: 10.1016/j.heliyon.2025.e42197
    BACKGROUND AND OBJECTIVE: Obesity is intricately linked with metabolic disturbances. The comprehensive exploration of metabolomes is important in unravelling the complexities of obesity development. This study was aimed to discern unique metabolite signatures in obese and lean individuals using liquid chromatography-mass spectrometry quadruple time-of-flight (LC-MS/Q-TOF), with the goal of elucidating their roles in obesity.

    METHODS: A total of 160 serum samples (Discovery, n = 60 and Validation, n = 100) of obese and lean individuals with stable Body Mass Index (BMI) values were retrieved from The Malaysian Cohort biobank. Metabolic profiles were obtained using LC-MS/Q-TOF in dual-polarity mode. Metabolites were identified using a molecular feature and chemical formula algorithm, followed by a differential analysis using MetaboAnalyst 5.0. Validation of potential metabolites was conducted by assessing their presence through collision-induced dissociation (CID) using a targeted tandem MS approach.

    RESULTS: A total of 85 significantly differentially expressed metabolites (p-value <0.05; -1.5 < FC > 1.5) were identified between the lean and the obese individuals, with the lipid class being the most prominent. A stepwise logistic regression revealed three metabolites associated with increased risk of obesity (14-methylheptadecanoic acid, 4'-apo-beta,psi-caroten-4'al and 6E,9E-octadecadienoic acid), and three with lower risk of obesity (19:0(11Me), 7,8-Dihydro-3b,6a-dihydroxy-alpha-ionol 9-[apiosyl-(1->6)-glucoside] and 4Z-Decenyl acetate). The model exhibited outstanding performance with an AUC value of 0.95. The predictive model underwent evaluation across four machine learning algorithms consistently demonstrated the highest predictive accuracy of 0.821, aligning with the findings from the classical logistic regression statistical model. Notably, the presence of 4'-apo-beta,psi-caroten-4'-al showed a statistically significant difference between the lean and obese individuals among the metabolites included in the model.

    CONCLUSIONS: Our findings highlight the significance of lipids in obesity-related metabolic alterations, providing insights into the pathophysiological mechanisms contributing to obesity. This underscores their potential as biomarkers for metabolic dysregulation associated with obesity.

  7. Nasir SM, Yahya N, Yap KH, Manan HA
    Heliyon, 2025 Feb 15;11(3):e41987.
    PMID: 39995935 DOI: 10.1016/j.heliyon.2025.e41987
    BACKGROUND: Post-COVID-19 condition (Long COVID) refers to a condition in which patients endure persistent symptoms for more than 12 weeks, typically occurring at least 3 months after the onset of Coronavirus disease 2019 (COVID-19) infection. It occurs when a constellation of symptoms persists following the initial illness, and this may obstruct a daily routine and impose difficulty in life. Therefore, this study aimed to systematically review published articles assessing the neurocognitive profile of long COVID patients, with a specific emphasis on executive function (EF), and to determine the correlation between EF deficits and brain alterations through the utilisation of neuroimaging modalities.

    METHODS: A thorough search was conducted using the PubMed/MEDLINE and Web of Science online databases following the PICOS and PRISMA 2020 guidelines. All included studies were deemed to be of high quality according to the Newcastle-Ottawa Scale (NOS).

    RESULTS: A total of 31 out of 3268 articles were included in the present study. The main outcome is the proportion of individuals with cognitive deficits, particularly in the EF domain, as detected by neuropsychological assessments. The present study also revealed that EF deficits in long COVID patients are correlated with disruptions in the frontal and cerebellar regions, affecting processes such as nonverbal reasoning, executive aspects of language, and recall. This consistent disturbance also emphasised the correlation between EF deficits and brain alterations in patients with long COVID.

    CONCLUSION: The present study highlights the importance of evaluating EF deficits in long COVID patients. This insight has the potential to improve future treatments and interventions.

  8. Ma L, Chee CS, Amri S, Gao X, Wang Q, Wang N, et al.
    PeerJ, 2025;13:e18952.
    PMID: 39995991 DOI: 10.7717/peerj.18952
    BACKGROUND: The professional development of teachers in the digital age will positively impact the effectiveness of physical education teaching. Exploring key factors such as self-efficacy, burnout, and digital technology is crucial to ensure the professional development of teachers.

    METHODS: The search was conducted in accordance with the PRISMA guidelines and utilized the following databases: Scopus, Web of Science, ProQuest, and Google Scholar. Inclusion and exclusion criteria: population, research methods, keywords, and time limit were described for this study. This article predominantly includes cross-sectional studies, so we have used the AXIS risk assessment methodology.

    RESULTS: The study included ten articles, seven of which (70%) were quantitative. Three key findings emerged from this review: first, the studies on self-efficacy were more noteworthy than the studies on burnout. Second, female teachers were more expressive in their digital teaching, while male teachers had higher levels of self-efficacy in their digital teaching. Finally, the study explored various factors affecting self-efficacy and burnout in relation to digital teaching. The study demonstrated that professional development has a higher impact on physical education teachers' self-efficacy, and in turn, self-efficacy reduces burnout. Additionally, burnout had a significant impact on professional development.

    CONCLUSION: This study describes the limitations of risk assessment and uses the AXIS tool to assess the methodological quality of this review report instead of using the risk of bias tool. The use of digital teaching methods can increase self-efficacy and alleviate burnout among physical education teachers. This review analyses the effects of digital technology, self-efficacy, and burnout on the career progression of physical education instructors and examines the implications for future developments.

    MeSH terms: Female; Humans; Male; Physical Education and Training*; Staff Development; Self Efficacy*
  9. Bejrananda T, Khaing W, Veettil SK, Thongseiratch T, Chaiyakunapruk N
    Eur Urol Open Sci, 2025 Feb;72:17-28.
    PMID: 39996029 DOI: 10.1016/j.euros.2025.01.011
    BACKGROUND AND OBJECTIVE: Robotic-assisted radical prostatectomy (RARP) is a surgical option for localized prostate cancer. Cost-effectiveness analysis (CEA) findings are inconsistent when comparing it with open (ORP) and laparoscopic (LRP) radical prostatectomy approaches. We performed a systematic review and meta-analysis to pool the incremental net benefit (INB) of these approaches.

    METHODS: Relevant CEA studies of RARP were identified by searching the PubMed, Embase, Scopus, International Health Technology Assessment database, Tufts CEA Registry, and Centre for Reviews and Dissemination databases from January 2005 to October 2023. To be included, studies must compare costs, and quality-adjusted life years (QALYs) of RARP versus ORP or LRP, and report the incremental cost per QALY gained. Study characteristics, economic model, costs, and outcomes were extracted. INBs were calculated in 2022 US dollars adjusted for purchasing power parity. A pooled analysis was performed using a random-effect model stratified by country income level. Heterogeneity was assessed using the Q test and I2 statistic.

    KEY FINDINGS AND LIMITATIONS: Thirteen studies with 17 comparisons, ten from high-income (HICs) and three from middle-income (MICs) countries, were included. Ten and five studies compared RARP with ORP and LRP, respectively. From a payer perspective, RARP was cost effective but not statistically significant compared with LRP in HICs (pooled INB: $7507.83 [-$1193.03 to $16 208.69], I2 = 81.15%) and not cost effective in MICs (%; -$4499.39 [-$16 500 to $7526.87], I2 = 17.15%). RARP showed no statistically significant cost effectiveness over ORP in both HICs ($3322.38 [-$1864.39 to $8509.15], I2 = 90.89%) and MICs ($2222.60 [-$2960.64 to $7405.83], I2 = 58.92%).

    CONCLUSIONS AND CLINICAL IMPLICATIONS: RARP is cost effective compared with LRP in HICs but lacks statistical significance. When compared with ORP, RARP is not cost effective in HICs and MICs. Our findings may support decision-making for prostate cancer treatment options in countries with different health care systems, especially those with limited resources.

    PATIENT SUMMARY: Our systematic review and meta-analysis provide important information regarding robotic-assisted radical prostatectomy (RARP) compared with open (ORP) and laparoscopic (LRP) radical prostatectomy. In high-income countries, RARP is generally cost effective compared with LRP, but not with ORP, while in middle-income countries, RARP is not cost effective compared with LRP or ORP. The findings of this review can support decision-making for prostate cancer treatment options.

  10. Aziz F, Sooriamoorthy S, Liew B, Syed Ahmad SM, Chong WW, Malek S, et al.
    Digit Health, 2025;11:20552076241309505.
    PMID: 39996067 DOI: 10.1177/20552076241309505
    OBJECTIVE: In multi-ethnic Malaysian populations, understanding and improving medication adherence in arthritis patients is crucial for enhancing treatment outcomes. Non-adherence, whether intentional or due to complex factors, can lead to severe long-term consequences such as increased disability and disease progression. This study analysed and predicted Malaysian arthritis medication adherence using 13 machine learning models.

    METHODS: A majority of 151 responders (82.1%) were female and 58.3% had comorbid illnesses. Notably, 90.07% of respondents were non-adherence to their prescription, with significant differences by occupation and aids in medication. This study's machine learning models perform better with recursive feature elimination for feature selection. Key variables included occupation, presence of other diseases, religion, income, medication aid, marital status, and number of medications taken per day. These variables were used to build predictive models for medication adherence.

    RESULTS: Results from machine learning algorithms showed varied performance. Support vector machine, gradient boosting, and random forest models performed best with AUC values of 0.907, 0.775, and 0.632 utilizing all variables. When using selected variables, random forest (AUC = 0.883), gradient boosting (AUC = 0.872), and Bagging (AUC = 0.860) performed best. Model interpretation using SHapley Additive exPlanations analysis identified occupation as the most important variable affecting medication adherence. The study also found that unemployment, concomitant disease, income, medication aid type, marital status, and daily medication count are connected with non-adherence.

    CONCLUSION: The findings underscore the multifaceted nature of medication adherence in arthritis, highlighting the need for personalized approaches to improve adherence rates.

  11. Islamiyati A, Nur M, Salam A, Muhamad WZAW, Auliyah D
    MethodsX, 2025 Jun;14:103186.
    PMID: 39996107 DOI: 10.1016/j.mex.2025.103186
    The risk factors for stunting incidence involve categorical data in both the response and predictor variables. Therefore, we developed a sparse categorical principal component logistic regression model capable of handling data with multicollinearity. The parameters of the sparse categorical principal component logistic regression model were estimated using the maximum likelihood method and the Newton-Raphson iterative approach. The analysis yielded a likelihood ratio value of 144.81 and a chi-square statistic value of 11.07, indicating that all factors included in the model are statistically significant. The results highlight that medical history, inadequate complementary feeding, formula feeding, lack of complementary feeding programs, and lack of iron supplementation for mothers are highly associated with the risk of stunting in toddlers. This emphasizes the need for attention to maternal nutrition from pregnancy through breastfeeding, as well as the nutrition of the toddler. Some important points proposed in this method are:•Stunting data consists of categorical variables containing multicollinearity.•The method applied is sparse logistic regression combined with categorical principal component analysis.•Analysis of risk factors for stunting in toddlers is based on the child's own condition, as well as parental factors, namely age, education, and intake of additional food and supplementary tablets during pregnancy.
  12. Yano AA, Astuti D, Respati AN, Ningsih N, Triswanto, Purnamayanti L, et al.
    J Sci Food Agric, 2025 Feb 25.
    PMID: 39996306 DOI: 10.1002/jsfa.14194
    BACKGROUND: Nowadays, there is increasing interest in optimizing the beneficial effects on egg quality and production by investigating various levels and sources of Se.

    METHODS: Data of various forms, sources and levels of Se were analyzed using a meta-analysis approach in terms of their effects on production, antioxidant activity and egg Se deposition of laying hens by using 81 peer-reviewed publications.

    RESULTS: Overall, laying hens' performance and egg quality attributes were not affected by Se supplementation, except for minor changes in egg weight and eggshell thickness in response to higher Se levels in diets. Noticeable effects were found on antioxidant activities where organic Se outperformed the inorganic form. Strong linear relationships between Se levels in the diet and Se content of whole egg, egg yolk and egg albumen were found where Se in the form of selenomethionine (SM) exhibited a stronger relationship with Se content in whole egg (R2 = 0.954), egg yolk (R2 = 0.972) and egg albumen (R2 = 0.926) than other forms of organic Se and inorganic Se (sodium selenite). Also observed was a Se preferential deposition in egg yolk compared with egg albumen especially for SM, indicating a higher bioavailability and deposition rate of SM than other Se sources.

    CONCLUSION: Various forms of Se could be safely supplemented to diets at high doses of up to 5 mg kg-1 without adversely affecting hens' performance while enhancing antioxidant status. Supplementation with SM could be the most effective strategy to improve egg Se status among other forms of Se which may be beneficial for consumers. © 2025 Society of Chemical Industry.

  13. Oktavian P, Kencono Wungu CD, Mudjanarko SW, Amin IM
    Diabetes Obes Metab, 2025 May;27(5):2658-2669.
    PMID: 39996365 DOI: 10.1111/dom.16268
    AIMS: This study aimed to summarize and compare the evidence on the efficacy and safety of automated insulin delivery (AID) systems using ultra-rapid-acting insulin analogues (URAIs), such as fast-acting insulin aspart (FIASP) and ultra-rapid lispro (URLi) (referred to as AID-URAIs), versus those using rapid-acting insulin analogues (RAIs) (referred to as AID-RAIs) in patients with type 1 diabetes (T1D).

    MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of AID-URAI versus AID-RAI. We systematically searched PubMed, Scopus, ProQuest, Web of Science, Cochrane Library, Clinicaltrial.gov, and medRxiv for articles up to 30 October 2024. Percent time-in-range (TIR; 3.9-10 mmol/L), time-below-range (TBR; 3.9- and 3.0-mmol/L), and time-above-range (TAR; >10.0- and 13.9-mmol/L) were extracted. This study was registered in the PROSPERO (CRD42024602279).

    RESULTS: Sixteen randomized controlled trials (664 participants) were included in this study. AID-URAI were associated with an increased percentage of TIR, but not clinically significant (pooled mean difference {MD} = 1.07% [95% confidence interval {CI}: 0.11 to 2.02]; I2 = 0%; p = 0.029; high certainty). The favourable effect was consistent in AID systems incorporating automated bolus correction, adults, study duration >4 weeks, and FIASP subgroups. AID-URAI has a 0.35% lower percentage of TBR (<3.9 mmol/L) compared with AID-RAI. There were no significant differences in the risk of diabetic ketoacidosis and severe hypoglycemia between the two groups.

    CONCLUSIONS: AID-URAI slightly improves the percentage of TIR and has a good safety profile without increasing the risk of diabetic ketoacidosis and severe hypoglycemia.

    MeSH terms: Blood Glucose/analysis; Humans; Hypoglycemia/chemically induced; Insulin Infusion Systems*; Randomized Controlled Trials as Topic; Insulin Aspart/administration & dosage
  14. Fauzi MSA, Sabri MSA, Halim AAA, Abidin SAIZ
    J Stomatol Oral Maxillofac Surg, 2025 Feb;126(1):101999.
    PMID: 39089510 DOI: 10.1016/j.jormas.2024.101999
    BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with prolonged bisphosphonate therapy. Increasing evidence shows that mucosal damage plays an important role in the pathogenesis of MRONJ. This study investigates the combinatorial effects of hydroxyapatite with Tualang honey on cell viability and wound healing in MRONJ.

    MATERIALS AND METHODS: The incorporation of Tualang honey into hydroxyapatite was assessed using Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) and field emission scanning electron-energy dispersive X-ray analysis microscopy (FESEM-EDX). The effect of hydroxyapatite combined with Tualang honey on cell viability was determined by WST-1 assay and wound healing was assessed by scratch assay.

    RESULTS: The incorporation of Tualang honey into hydroxyapatite altered the functional groups, structure, size, morphology, and components of the crystal as evidenced by FTIR, XRD and FESEM-EDX analysis. High concentrations of pamidronic acid inhibit oral fibroblast viability and wound healing. Low and high concentrations of hydroxyapatite demonstrate non-toxicity towards fibroblast cells. Furthermore, hydroxyapatite reversed the action of pamidronic acid on the cells; it increased fibroblast viability but did not close the wound. Tualang honey promotes fibroblast viability and wound closure. However, the addition of Tualang honey is unable to overcome the inhibitory effects of pamidronic acid on fibroblasts. The addition of Tualang honey and hydroxyapatite improved the cell viability and accelerated wound closure of fibroblast exposed to pamidronic acid.

    CONCLUSION: These findings demonstrated that the combination treatment protects oral fibroblasts by preventing bisphosphonate toxicity.

    MeSH terms: Cells, Cultured; Diphosphonates/adverse effects; Diphosphonates/chemistry; Fibroblasts/drug effects; Fibroblasts/pathology; Honey*; Humans; Microscopy, Electron, Scanning; X-Ray Diffraction*; Spectroscopy, Fourier Transform Infrared; Bone Density Conservation Agents/adverse effects; Bone Density Conservation Agents/chemistry; In Vitro Techniques
  15. Sauki NSM, Damanhuri NS, Othman NA, Chiew YS, Meng BCC, Nor MBM, et al.
    Comput Methods Programs Biomed, 2025 May;263:108680.
    PMID: 39987666 DOI: 10.1016/j.cmpb.2025.108680
    BACKGROUND AND OBJECTIVE: Asynchronous breathing (AB) occurs when a mechanically ventilated patient's breathing does not align with the mechanical ventilator (MV). Asynchrony can negatively impact recovery and outcome, and/or hinder MV management. A model-based method to accurately classify different AB types could automate detection and have a measurable clinical impact.

    METHODS: This study presents an approach using a 1-dimensional (1D) of airway pressure data as an input to the convolutional long short-term memory neural network (CNN-LSTM) with a classifier method to classify AB types into three categories: 1) reverse Triggering (RT); 2) premature cycling (PC); and 3) normal breathing (NB), which cover normal breathing and 2 primary forms of AB. Three types of classifier are integrated with the CNN-LSTM model which are random forest (RF), support vector machine (SVM) and logistic regression (LR). Clinical data inputs include measured airway pressure from 7 MV patients in IIUM Hospital ICU under informed consent with a total of 4500 breaths. Model performance is first assessed in a k-fold cross-validation assessing accuracy in comparison to the proposed CNN-LSTM integrated with each type of classifier. Then, confusion matrices are used to summarize classification performance for the CNN without classifier, CNN-LSTM without classifier, and CNN-LSTM with each of the 3 classifiers (RF, SVM, LR).

    RESULTS AND DISCUSSION: The 1D CNN-LSTM with classifier method achieves 100 % accuracy using 5-fold cross validation. The confusion matrix results showed that the combined CNN-LSTM model with classifier performed better, demostrating higher accuracy, sensitivity, specificity, and F1 score, all exceeding 83.5 % across all three breathing categories. The CNN model without classifier and CNN-LSTM model without classifier displayed comparatively lower performance, with average values of F1 score below 71.8 % for all three breathing categories.

    CONCLUSION: The results validate the effectiveness of the CNN-LSTM neural network model with classifier in accurately detecting and classifying the different categories of AB and NB. Overall, this model-based approach has the potential to precisely classify the type of AB and differentiate normal breathing. With this developed model, a better MV management can be provided at the bedside, and these results justify prospective clinical testing.

    MeSH terms: Algorithms; Humans; Memory, Short-Term; Respiration; Respiration, Artificial*; Reproducibility of Results; Logistic Models; Neural Networks (Computer)*; Support Vector Machine
  16. Sulaiman NF, Zulkifli SZ, Saaidin AS, Lekkala R, Izzaty Hassan N, Pungot NH
    Eur J Med Chem, 2025 Apr 15;288:117412.
    PMID: 39987835 DOI: 10.1016/j.ejmech.2025.117412
    β-Carboline is a crucial compound in medicinal chemistry known for its versatile pharmacological activities. Recent research has focused on hybrid molecules incorporating a β-carboline scaffold linked to other pharmacophore moieties. These hybrid compounds have demonstrated diverse therapeutic properties, including anticancer, antianxiety, antimalarial, antidepressant, anti-inflammatory, antileishmanial, and antioxidant effects. This review highlights studies conducted from 2014 to the present with a particular emphasis on the development of β-carboline hybrid compounds and their derivatives as potent anticancer agents. The structure-activity relationship (SAR) analysis reveals that these hybrids exhibit significant cytotoxicity against various cancer cell lines. This review aims to inspire further research into the novel synthesis and evolution of β-carboline hybrids and their derivatives, potentially leading to new therapeutic advancements.
    MeSH terms: Animals; Drug Screening Assays, Antitumor; Humans; Structure-Activity Relationship; Molecular Structure; Cell Proliferation/drug effects
  17. Yusoff NM, Suleiman N, Abdul-Hamid AQ, Ali MH
    J Environ Manage, 2025 Mar;377:124552.
    PMID: 39987864 DOI: 10.1016/j.jenvman.2025.124552
    Water is an indispensable resource in the food sector, playing a critical role in production processes. However, wastewater generation presents significant challenges, including the opportunity to recover valuable resources. Wastewater reclamation within the food sector has emerged as a crucial practice, offering potential benefits such as economic efficiency, societal well-being, technological advancement, and environmental preservation. This study conducts a systematic literature review (SLR) to consolidate fragmented research and provide a comprehensive overview of the current state of wastewater reclamation in the food sector. This review analyses 51 articles published between 2013 and 2025, sourced from the Scopus and Web of Science database. The review synthesizes existing research and organizes it into two primary dimensions: (1) the factors influencing the implementation of wastewater reclamation in the food industry and (2) the benefits and barriers associated with these practices. The study classifies these factors into five key domains: water consumption, water generation, technological innovation, wastewater utilization, and reuse practices. It further highlights the crucial role of technical considerations in addressing barriers and maximizing the benefits of wastewater reclamation. The paper contributes to the scientific understanding of wastewater reclamation by proposing five key propositions that form a novel interconnected theoretical framework. This framework offers new insights into the complex dynamics of wastewater management in the food sector and identifies emerging trends. The study underscores the importance of aligning wastewater reclamation technologies with business objectives and encourages policymakers to implement robust environmental standards that facilitate sustainable practices.
    MeSH terms: Waste Disposal, Fluid/methods; Food Industry; Waste Water*
  18. Chua SN, Chong JE, Chee Lee KY, Kharbanda V, Ren Y, Pinheiro-Mehta N, et al.
    Death Stud, 2025 Feb 23.
    PMID: 39988477 DOI: 10.1080/07481187.2025.2468169
    Suicide-related stigma pervades both healthcare systems and communities, affecting individuals and their social circles. This study aimed to explore lived experience perspectives on the public stigma of suicide in Malaysia using community-based participatory research (CBPR). Nineteen individuals with a history of suicide ideation and/or suicide attempt attended 90-minute virtual focus groups conducted in 2022. Thematic analysis revealed 19 stereotypes, 7 prejudices, and 6 forms of discrimination. Stereotypes ranged from attention-seeking to weak faith, while prejudices included feelings of anger and fear. Discrimination manifested through avoidance and social rejection. Despite benevolent intentions, such actions sometimes hinder personal growth of the person with lived experience. While some findings echoed previous research, others highlighted unique Malaysian perspectives. Despite limitations, this study emphasizes the need to address culture-specific stigma, offering pathways for intervention. Understanding and combatting stigma remain critical for supporting individuals grappling with suicidal ideation and attempts in Malaysian society.
  19. Ahmad SR, Hanafi S
    Clin Genet, 2025 Feb 23.
    PMID: 39988558 DOI: 10.1111/cge.14733
    Agenesis of the corpus callosum with peripheral neuropathy (ACCPN) is a rare autosomal recessive disorder characterized by malformation or absence of the corpus callosum, accompanied by progressive peripheral nerve degeneration. ACCPN is associated with mutations in the SLC12A6 gene, encoding the potassium-chloride cotransporter (also termed KCC3), which plays a crucial role in neuronal ion homeostasis. In this study, we report a novel homozygous missense variant (c.1634A>G, p.H371R) in SLC12A6, identified through exome sequencing in a male proband presenting with ACCPN symptoms, including developmental delay, hypotonia, epileptic seizures, and corpus callosal dysgenesis. The proband's MRI findings revealed additional neurodevelopmental abnormalities such as hippocampal malformation. Functional analysis showed that while the mutant SLC12A6 transcript and protein levels were comparable to wild type, the mutant protein was mislocalized to the cytoplasm, disrupting its ion transport function. This mislocalization caused an imbalance in potassium and chloride ion levels in the proband's cells. Bioinformatics tools predicted the pathogenicity of the p.H371R mutation, and structural modeling revealed a destabilization effect. Elevated levels of cellular senescence markers, p16 and p21, were detected, indicating that ion dysregulation due to SLC12A6-p.H371R mislocalization contributed to cellular stress. This study provides novel insights into the pathogenic mechanism of ACCPN, highlighting the importance of mutant SLC12A6 mislocalization and ion homeostasis in disease progression. The identification of the p.H371R mutation adds to the spectrum of SLC12A6 mutations linked to ACCPN and underscores the potential for targeted therapeutic strategies.
  20. Lim SY, Toh TS, Hor JW, Lim JL, Lit LC, Ahmad-Annuar A, et al.
    NPJ Parkinsons Dis, 2025 Feb 23;11(1):34.
    PMID: 39988587 DOI: 10.1038/s41531-025-00884-6
    LRRK2-related Parkinson's disease (LRRK2-PD) is the most frequent form of monogenic PD worldwide, with important therapeutic opportunities, exemplified by the advancement in LRRK2 kinase inhibition studies/trials. However, many LRRK2 variants, especially those found in underrepresented populations, remain classified as variants of uncertain significance (VUS). Leveraging on Malaysian, Singaporean, and mainland Chinese PD datasets (n = 4901), we describe 12 Chinese-ancestry patients harboring the LRRK2 p.Arg1067Gln variant, more than doubling the number of previously reported cases (total n = 23, 87% East Asian, mean age of onset: 53.9 years). We determine that this variant is enriched in East Asian PD patients compared to population controls (OR = 8.0, 95% CI: 3.0-20.9), and provide supportive data for its co-segregation with PD, albeit with incomplete penetrance. Utilizing established experimental workflows, this variant showed increased LRRK2 kinase activity, by ~2-fold compared to wildtype and higher than the p.Gly2019Ser variant. Taken together, p.Arg1067Gln should be reclassified from a VUS to pathogenic for causing LRRK2-PD.
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