METHODS: This cross-sectional survey recruited participants using universal sampling from a major hospital in Selangor, Malaysia. Participants answered questionnaires consisting of demographic and clinical information (medical history, duration of anti-depressant treatment for MDD, psychiatric ward admission history, and any medication side effects experienced), the Internalized Stigma of Mental Illness Scale (comprising alienation, stereotype, perceived discrimination, and social withdrawal), the Multidimensional Scale of Perceived Social Support (comprising family, friend, and significant other support), and the Malaysia Medication Adherence Assessment Tool. Simple and multiple logistic regression and mediation analyses were conducted.
RESULTS: Of the 268 participants (69% female), 57.1% were suboptimally or moderately adherent to their medication. Buddhists (adjusted odds ratio [aOR] = 0.280, 95% CI [0.115, 0.679], p = 0.005), higher family support (aOR = 0.753, 95% CI [0.591, 0.960], p = 0.022), a history of ward admissions (aOR = 3.523, 95% CI [1.537, 8.072], p = 0.003), and higher internalized stigma (aOR = 2.828, 95% CI [1.497, 5.344], p = 0.001) were significantly associated with low/moderate medication adherence. The effect of internalized stigma subdomains (alienation, perceived discrimination, and social withdrawal) on medication adherence were partially mediated by family support.
CONCLUSION: More than half of the participants demonstrated low to moderate medication adherence. Those with higher internalized stigma demonstrated higher odds of low/moderate medication adherence, but this effect was attenuated by family support. Therefore, internalized stigma and family support are important points of consideration when assessing patients with MDD in Malaysia.
METHODS: The study investigated the impact of characterized UC-MSC-sEVs on various aspects including the proliferation, migration, antioxidant activity, and ECM gene expression of human dermal fibroblasts (HDF). Additionally, the effects of UC-MSC-sEVs on the proliferation, melanin content, and tyrosinase (TYR) activity of human melanoma cells (MNT-1) were examined. Furthermore, ex vivo models were employed to evaluate the skin permeation of PKH26-labelled UC-MSC-sEVs.
RESULTS: The findings indicated that a high concentration of UC-MSC-sEVs positively influenced the proliferation of HDF. However, no changes in cell migration rate were observed. While the expressions of collagen type 1 and type 3 remained unaffected by UC-MSC-sEVs treatment, there were dose-dependent increases in the gene expressions of fibronectin, matrix metallopeptidase (MMP) 1, and MMP 3. Furthermore, UC-MSC-sEVs treatment did not impact the antioxidative superoxide dismutase (SOD) expression in HDF. Although UC-MSC-sEVs did not alter the proliferation of MNT-1 cells, it did result in a dose-dependent reduction in melanin synthesis without affecting TYR activity. However, when it was applied topically, UC-MSC-sEVs failed to penetrate the skin barrier and remained localized within the stratum corneum layer even after 18 hours.
CONCLUSION: These results highlight the potential of UC-MSC-sEVs in stimulating HDF proliferation, regulating ECM synthesis, and reducing melanin production. This demonstrates the promising application of UC-MSC-sEVs in medical aesthetics for benefits such as scar reduction, skin rejuvenation, and skin lightening.
METHODS: A cohort retrospective study was conducted at a leading tertiary care hospital in Saudi Arabia spanning from January 2023 to January 2024 in a psychiatry setting. The study comprehensively examined all instances of interventions for DRPs facilitated through patient-initiated telepsychiatry encounters with psychiatric clinical pharmacists. Detailed and meticulously recorded notes from patient chart reviews, documented by the pharmacist in the Electronic Health Record (EHR), during each encounter, were reviewed. These notes provided significant information on psychiatric diagnosis, identified DRPs and the specific interventions and recommendations proposed by the clinical pharmacist to the attending physician. The Krska classification was utilised to classify and analyse the identified DRPs, ensuring a structured and systematic approach to the study's findings.
RESULTS: A total of 259 pharmacist interventions were made, and the results revealed a remarkably high acceptance rate of 98.5% among physicians. The most common intervention (16.21%) involved targeted education to improve medication adherence. Additionally, substantial efforts were directed towards rectifying inappropriate dosage regimens, accounting for 13.51% of DRPs resolved by the pharmacist. Noteworthy interventions also encompassed the identification and management of potential or suspected adverse reactions, comprising 12.35% of the interventions, along with interventions addressing concerns regarding potentially ineffective therapy, which constituted 11.59%.
CONCLUSION: The study underscores the critical role of pharmacists in psychiatric care, with high physician acceptance of their interventions. The diverse range of DRPs highlights the need to expand clinical pharmacy services and integrate pharmacists into psychiatric teams. Our findings clearly demonstrate that integrating pharmacists into psychiatric care settings is beneficial. This approach enhances DRP identification and management, ultimately enhancing patient care and treatment outcomes.
METHODS: A systematic search for observational studies that compared the level of agreement among pathologists between WHO and binary grading systems for ED was conducted using three databases: Medline, Scopus, and EBSCOhost. For the meta-analysis, summary estimations of kappa value (κ) and standard error (SE) were utilized.
RESULTS: The pooled analysis of observations by 46 pathologists from a total of eight studies showed better interobserver agreement in the interpretation of ED for the binary system (κ = 0.31; 95% confidence interval [CI], 0.23-0.40) in comparison with the WHO (κ = 0.14; 95% CI, 0.10-0.19). The intra-observer agreement was reported only by five studies and was also found to be higher for the binary system (κ = 0.44; 95% CI, 0.31-0.57) compared to the WHO (κ = 0.25; 95% CI, 0.11-0.39).
CONCLUSIONS: Our results validate that the binary system has better overall intra-observer and interobserver agreement than the WHO system. Further studies with larger cohorts are mandatory before clinically relevant conclusions are drawn, as evidence remains inadequate.
METHODS: A prospective, open-label trial of 310 people with HIV and opioid use disorder at Malaysia's largest prison were allocated to pre-release methadone up to 24 weeks before release or not by randomization (n = 64) or preference (n = 246); 296 were included in the final analytical sample. Directed acyclic graphing was used to theorize the relationship between pre-release methadone and post-release linkage to HIV care and identify confounding variables. An inverse probability weighted Cox proportional hazards model estimated the impact of pre-release methadone on linkage to HIV care through 360 days after release.
RESULTS: Overall, 218 (73.6 %) of 296 study participants initiated methadone before release. Receiving pre-release methadone significantly predicted linkage to HIV care at all time points through 360 days (aHR = 1.87; 95 % CI 1.15-2.85) after release. The corresponding numbers needed to treat with pre-release methadone for one increased linkage to HIV care at 30 and 360 days were 14 (95 % CI 9.2-62.4) and 5 (95 % CI 3.4-22.0), respectively.
CONCLUSIONS: While treatment with methadone should be available to everyone with opioid use disorder, it should especially be included as part of an HIV treatment-as-prevention strategy for people in prisons, especially by the time of release. It can optimize HIV treatment outcomes by jumpstarting the HIV treatment cascade.
METHODS: Based on the PRISMA method, this study used a meta-analytic approach to explore the relationship between mindfulness and problematic smartphone use systematically. Systematic literature searches for papers published before February 2024 yielded 29 studies, including 17,534 individuals and 30 effect sizes. The sample comprised participants from Eastern cultures (n = 22 studies) and Western cultures (n = 8 studies).
RESULTS: The meta-analysis revealed a significant negative correlation between mindfulness and problematic smartphone use (r = -0.399, 95 % CI [-0.457, -0.338], p
OBJECTIVE: This study explored the capabilities of digital healthy cities within the framework of digital transformation, focusing on member countries of the Asian Forum of Healthy Cities. It examined the cities' preparedness and policy needs for transitioning to digital health.
METHODS: A cross-sectional survey was conducted of 9 countries-Australia, Cambodia, China, Japan, South Korea, Malaysia, Mongolia, the Philippines, and Vietnam-from August 1 to September 21, 2023. The 6-section SPIRIT (setting approach and sustainability; political commitment, policy, and community participation; information and innovation; resources and research; infrastructure and intersectoral; and training) checklist was modified to assess healthy cities' digital capabilities. With input from 3 healthy city experts, the checklist was revised for digital capabilities, renaming "healthy city" to "digital healthy city." The revised tool comprises 8 sections with 33 items. The survey leveraged ChatGPT (version 4.0; OpenAI, Microsoft), accessed via Python (Python Software Foundation) application programming interface. The openai library was installed, and an application programming interface key was entered to use ChatGPT (version 4.0). The "GPT-4 Turbo" model command was applied. A qualitative analysis of the collected data was conducted by 5 healthy city experts through group deep-discussions.
RESULTS: The results indicate that these countries should establish networks and committees for sustainable digital healthy cities. Cambodia showed the lowest access to electricity (70%) and significant digital infrastructure disparities. Efforts to sustain digital health initiatives varied, with countries such as Korea focusing on telemedicine, while China aimed to build a comprehensive digital health database, highlighting the need for tailored strategies in promoting digital healthy cities. Life expectancy was the highest in the Republic of Korea and Japan (both 84 y). Access to electricity was the lowest in Cambodia (70%) with the remaining countries having had 95% or higher access. The internet use rate was the highest in Malaysia (97.4%), followed by the Republic of Korea (97.2%), Australia (96.2%), and Japan (82.9%).
CONCLUSIONS: This study highlights the importance of big data-driven policies and personal information protection systems. Collaborative efforts across sectors for effective implementation of digital healthy cities. The findings suggest that the effectiveness of digital healthy cities is diminished without adequate digital literacy among managers and users, suggesting the need for policies to improve digital literacy.
PURPOSE: The purpose of this in vitro study was to apply OCT to evaluate and to compare the impact of conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) fabrication methods and different materials, including bis-acryl, conventional polymethyl-methacrylate (PMMA), and CAD-CAM PMMA, on the marginal fit of interim crowns.
MATERIAL AND METHODS: Thirty crown specimens were fabricated, with 20 PMMA crowns divided into 2 groups based on the fabrication method: the conventional method (Group Jet, n=10) and the CAD-CAM method (Group CAD-CAM PMMA, n=10). An additional 10 bis-acryl crowns were fabricated using the conventional method (Group Protemp, n=10). The marginal gap was assessed at 8 specific points using swept-source OCT. Comparisons between the fabrication methods of PMMA crowns and different materials of conventionally made crown were done using an independent t test (α=.05).
RESULTS: Group CAD-CAM PMMA recorded statistically significant lower total mean vertical marginal gap values (22.2 ±4.7 µm) compared with group Jet (62.6 ±2.2 µm) (P