Browse publications by year: 2025

  1. Antu UB, Roy TK, Roshid MM, Mitu PR, Barman MK, Tazry J, et al.
    Int J Biol Macromol, 2025 Apr;303:140570.
    PMID: 39904432 DOI: 10.1016/j.ijbiomac.2025.140570
    Nanocellulose, a promising green material derived from various bio-sources, has potentiality on and off-site in the agricultural sector. Due to its special qualities, which include high strength, hydrophilicity, and biocompatibility, it is a material that may be used in a variety of industries, especially agriculture. This review explores in this article production processes, post-processing procedures, and uses of nanocellulose in soil fertility increment and sustainable agriculture. A variety of plant materials, agricultural waste, and even microbes can be used to isolate nanocellulose. Nanocellulose is produced using both top-down and bottom-up methods, each of which has benefits and limitations of its own. It can be applied as nano-biofertilizer in agriculture to enhance beneficial microbial activity, increase nutrient availability, and improve soil health. Moreover, nanocellulose can be used in fertilizer and pesticide formulations with controlled releases to increase efficacy and lessen environmental effects. Innovative approaches to sustainable agriculture are provided by nanocellulose technologies, which also support the UN's Sustainable Development Goals (SDGs), especially those pertaining to eradicating hunger and encouraging responsible consumption. Nanocellulose promotes climate action and ecosystem preservation by increasing resource efficiency and decreasing dependency on hazardous chemicals, ultimately leading to the development of a circular bioeconomy. Nonetheless, there are still issues with the high cost of production and the energy-intensive isolation procedures. Despite its various potentialities, challenges such as high production costs, environmental concerns, and regulatory issues must be addressed for nanocellulose to be widely adopted and effectively integrated into farming practices.
    MeSH terms: Fertilizers*; Nanostructures/chemistry
  2. Amin M, Rahardjo KKE, Panosa AE, Satyantini WH, Mukti AT, Ali M, et al.
    Fish Shellfish Immunol, 2025 Mar;158:110171.
    PMID: 39904479 DOI: 10.1016/j.fsi.2025.110171
    The etiological agent of white feces disease (WFD) infecting Pacific white shrimp Penaeus vannamei in Indonesia farms remains obscure. The present study aimed to identify possible causative agents of WFD infection in Pacific white shrimps cultured in Indonesian farms. WFD-infected and healthy samples (shrimp gut and rearing water) were collected from 8 commercial shrimp farms in East Java, Indonesia followed by bacterial community profiling using HiSeq sequencing of 16S rRNA gene amplicons. The results showed that the microbiota composition in the guts of WFD-infected shrimps was significantly different (p 
    MeSH terms: Gastrointestinal Microbiome*; Animals; Bacteria/classification; Bacteria/genetics; Bacteria/isolation & purification; Indonesia; Phylogeny; Aquaculture
  3. Rehman S, Saleem S, Zahra ST, Jabeen A
    Violence Vict, 2025 Feb 03.
    PMID: 39904531 DOI: 10.1891/VV-2024-0132
    In the Pakistani cultural context, dating violence is a pervasive issue that poses significant risks to mental health. This qualitative study aimed to explore the experiences and expressions of young adults who have faced dating violence, with a focus on informing counseling and early intervention. Through interpretative phenomenological analysis of semistructured interviews with 10 young adults (5 men and 5 women) aged 18-25 years, we identified superordinate themes of psychological, emotional, and physical modes of dating violence. Subordinate themes revealed a range of controlling and manipulating, stalking and surveillance, intimidating, isolation, communication gap, exploiting emotional dependency, ridiculing, lowering self-esteem and identity erosion, emotional distancing and neglect, humiliation and degradation, devaluation and defame, physical assault and injury, property damage, coercing or attempting sexual contact, and restraining and confinement. Our findings highlight the need for culturally sensitive intervention of dating violence in Pakistan including the integration of psychological support and emotional counseling, where societal pressure, family expectations, and gender roles exacerbate the abuse. This study contributes significantly to the understanding of dating violence in Pakistan and underscores the importance of tailored interventions to mitigate its devastating effects on mental health.
  4. Leong PY, Tan WQ, Choo WS
    FEMS Microbiol Lett, 2025 Feb 04.
    PMID: 39904546 DOI: 10.1093/femsle/fnaf020
    Antibiotic resistance and the persistence of sessile cells within biofilms complicate the eradication of biofilm-related infections using conventional antibiotics. This highlights the necessity for alternate therapy methods. The objective of this study was to investigate the biofilm destruction activity of α-tocopherol against Staphylococcus aureus, Proteus mirabilis and Pseudomonas aeruginosa on polystyrene. α-Tocopherol showed significant biofilm destruction activity on the pre-formed biofilms of S. aureus (45-46%), Pr. mirabilis (42-54%) and Ps. aeruginosa (28%). Resazurin assay showed that α-tocopherol disrupted all bacteria biofilms without interfering with their cell viability. Scanning electron microscope images showed lower bacterial cell count and less compacted cell aggregates on polystyrene surfaces after treatment with alpha-tocopherol. This study demonstrated the biofilm destruction activity of alpha-tocopherol against S. aureus, Pr. mirabilis and Ps. aeruginosa. α-Tocopherol could potentially be used to decrease biofilm-associated infections of these bacteria.
  5. Kwok FY, Hui MT, Thomas Joseph C, Hanim Binti Mohamad A, Bakhtiar MF
    PMID: 39904571 DOI: 10.1177/0310057X241284655
    Diagnosis of perioperative anaphylaxis (POA) and identification of causative agents remain challenging. This study aimed to describe the estimated incidence, characteristics and causative agents of POA in Malaysia. This is a retrospective review of all cases of suspected POA referred to the only anaesthetic allergy centre in Malaysia from March 2014 to December 2022. One hundred and ninety patients with suspected POA of Grade 2 and above were included. Data on clinical presentation, severity, management, serum tryptase and subsequent allergy workup (including skin and serum testing results) of these patients were extracted from the database. Dynamic tryptase was elevated in half of the cases where tryptase results were available and skin tests were positive in 96% of these cases. Skin testing was positive in 113 patients (60%) overall, and more than 70% of Grades 3 and 4 anaphylaxis cases. Neuromuscular blocking agents (NMBAs) and antibiotics were the most commonly identified causative agents (27.4% and 23% respectively). The commonest NMBAs were rocuronium and atracurium, both commonly cross-reacting with cisatracurium. The overall cross-reactivity rate among NMBAs was 58%. For antibiotics, the commonest causative agents were cefuroxime, ceftriaxone and amoxicillin/clavulanic acid. Using these data, the estimated incidence of Grades 2-4 POA over this period in Malaysia was approximately 1 in 30,000 anaesthetics. However, owing to the voluntary nature of reporting, it is possible that this is an underestimate, particularly in relation to some milder Grade 2 cases which may have gone unrecognised or unreported.
  6. Zulkeflee NN, Mustapha Kamil Y, Mashohor S, Abu Bakar MH
    Biosens Bioelectron, 2025 Jun 01;277:117200.
    PMID: 39904660 DOI: 10.1016/j.bios.2025.117200
    This work demonstrates a label-free dual-sensing biosensor utilizing cascaded single-mode tapered fiber (SMTF) for the concurrent detection of Dengue II envelope (E) and SARS-CoV-2 spike (S) proteins. Two fiber tapers of different dimensions were employed in-line, with each taper functionalized with specific complementary antibodies to the targeted antigens. The cascaded interferometric effect yielded composite spectral output that exhibited discrete response toward localized refractive index changes due to binding of antigens and antibodies. Consistent red shifts were observed with increasing concentration of the targeted analyte, which led to sensitivity values of 6.91 nm/nM for SMTF1 and 9.96 nm/nM for SMTF2, with a detection limit of 0.1 pM. This dual-sensing platform demonstrates high sensitivity and specificity, rapid response times, and the potential for integration into portable diagnostic devices, presenting it as a promising tool for point-of-care diagnostics and simultaneous detection of multiple disease biomarkers.
    MeSH terms: Equipment Design; Humans; Viral Envelope Proteins; Optical Fibers*; Limit of Detection*
  7. Nahin KH, Nirob JH, Taki AA, Haque MA, SinghSingh NS, Paul LC, et al.
    Sci Rep, 2025 Feb 04;15(1):4215.
    PMID: 39905042 DOI: 10.1038/s41598-025-88174-2
    This paper introduces the design and exploration of a compact, high-performance multiple-input multiple-output (MIMO) antenna for 6G applications operating in the terahertz (THz) frequency range. Leveraging a meta learner-based stacked generalization ensemble strategy, this study integrates classical machine learning techniques with an optimized multi-feature stacked ensemble to predict antenna properties with greater accuracy. Specifically, a neural network is applied as a base learner for predicting antenna parameters, resulting in increased predictive performance, achieving R², EVS, MSE, RMSE, and MAE values of 0.96, 0.998, 0.00842, 0.00453, and 0.00999, respectively. Utilizing regression-based machine learning, antenna parameters are optimized to attain dual-band resonance with bandwidths of 3.34 THz and 1 THz across two bands, ensuring robust data throughput and communication stability. The antenna, designed with dimensions of 70 × 280 μm², demonstrates a maximum gain of 15.82 dB, excellent isolation exceeding - 32.9 dB, and remarkable efficiency of 99.8%, underscoring its suitability for high-density, high-speed 6G environments. The design methodology integrates CST simulations and an RLC equivalent circuit model, substantiated by ADS simulations, with comparable reflection coefficients validating the accuracy of the models. With its compact footprint, broad bandwidth, and optimized isolation and efficiency, the proposed MIMO antenna is positioned as an ideal candidate for future 6G communication applications.
  8. Gong Y, Said F, Haq W, Gong J, Aksar I
    Sci Rep, 2025 Feb 04;15(1):4212.
    PMID: 39905199 DOI: 10.1038/s41598-025-87343-7
    The COVID-19 pandemic has given rise to unprecedented transformation of consumer behaviors. Despite the abundance of research on this subject, less is known about why and how consumers processed health information and subsequently decided to purchase food during the pandemic. This study employed a survey questionnaire to collect the data. The sample size consisted of 590 consumers in China. The data were analyzed via SPSS and SmartPLS version 3.2.9 to explore the relationships among variables. The results showed that health information-seeking behavior has a significant impact on healthy food product purchasing intention. Similarly, health-related internet use also has a positive impact on health information seeking. Moreover, the impact of motivation for healthy eating on health information seeking is significant. The results indicate a significant moderating role of social influence (i.e., interaction between health information seeking and healthy food product purchasing intention). Multigroup analysis revealed differences between income and age in terms of health-related internet use and purchasing intention. This study assessed healthy food product purchasing intention in a timely manner by incorporating health communication. variables and social influence into consumer behavior research in the context of COVID-19. It thus expands the extant literature and provides insights into the knowledge and practices concerned.
    MeSH terms: Adolescent; Adult; China; Female; Humans; Male; Middle Aged; Motivation; Surveys and Questionnaires; Intention*; Young Adult; Functional Food*; Information Seeking Behavior*; Pandemics
  9. Bujang MA, Lai WH, Tiong XT, Ratnasingam S, Kim ARJ, Husin M, et al.
    BMC Public Health, 2025 Feb 04;25(1):443.
    PMID: 39905413 DOI: 10.1186/s12889-025-21475-3
    BACKGROUND: Chronic diseases are known to detrimentally impact an individual's quality of life (QOL) and well-being. Therefore, this study aims to evaluate the QOL and overall well-being among both healthy individuals and those with diverse primary diagnoses.

    METHODS: This is a cross-sectional study and data collection took place from May 2022 to May 2023. Information regarding healthy participants was gathered from healthcare workers without any comorbidities. Data for non-healthy participants were collected from individuals diagnosed with various conditions across four specialist clinics: nephrology, oncology, psychiatry, and cardiology. All participants completed the Significant Quality of Life Measures (SigQOLM), a comprehensive assessment tool consisting of 69 items that evaluate 18 domains of QOL and well-being.

    RESULTS: The study included a total of 452 participants, with 284 (62.8%) classified as healthy. Among the non-healthy participants, 41 (9.1%) had end-stage renal diseases (ESRD), 48 (10.6%) were diagnosed with cancer, 40 (8.8%) had depressive disorder, and the remaining had heart disease (8.6%). Statistical analysis revealed significant differences (p 

    MeSH terms: Adult; Aged; Chronic Disease/psychology; Cross-Sectional Studies; Female; Heart Diseases/diagnosis; Heart Diseases/psychology; Humans; Kidney Failure, Chronic/psychology; Male; Middle Aged; Neoplasms/psychology; Surveys and Questionnaires
  10. Selamat R, Aziz NAA, Raib J, Zulkafly N, Mohamad WAW, Ismail AN, et al.
    BMC Public Health, 2025 Feb 04;24(Suppl 1):3629.
    PMID: 39905418 DOI: 10.1186/s12889-025-21671-1
    BACKGROUND: School-based obesity interventions are a promising strategy for combating childhood obesity. In this study, we examined the efficacy of the "My Body is Fit and Fabulous at School" (MyBFF@school) program with a nutrition education intervention (NEI) for improving nutrition knowledge and attitude among overweight and obese primary schoolchildren.

    METHODS: A school-based cluster randomized controlled trial of the MyBFF@school obesity intervention program was conducted among overweight and obese schoolchildren aged 9-11. Out of 1,196 eligible government primary schools in central Peninsular Malaysia, 23 were randomly assigned into seven intervention schools (647 children) and 16 control schools (750 children). A standard nutrition education module was delivered for 24 weeks to the intervention group, whereas children in the control group followed only the currently existing school nutrition education program. The main outcome measures were nutrition knowledge and attitude scores. Changes of nutrition knowledge and attitude scores from follow up until end of 6 months was assessed using the mixed effect model taking into account the cluster effect.

    RESULTS: A total of 563 children in the intervention group and 482 in the control group completed the six-month program and were included in the analysis. The overall nutrition knowledge score was significantly higher in the intervention group (adjusted mean difference (AMD): 4.75%, p = 0.028 ) after controlling for mean nutrition knowledge score at baseline, gender, location school group (intervention vs control) and ethnicity. There was also a significant improvement in the nutrition knowledge score with AMD among boys (6.02%), urban children (8.07%), and non-Malays (10.4%). In contrast, after controlling for mean nutrition attitude score at baseline, gender, location, school group (intervention vs control) and ethnicity, there was no significant difference in the nutrition attitude scores between the intervention and the control groups in the overall, gender, location and ethnicity.

    CONCLUSIONS: The MyBFF@school program with an adjunct NEI improves the overall knowledge on nutrition but has no positive effect on the nutrition attitude of younger schoolchildren, necessitating additional improvements.

    TRIAL REGISTRATION: Clinical trial number: NCT04155255, November 7, 2019 (Retrospective registered). National Medical Research Register: NMRR-13-439-16563. Registered July 23, 2013. The intervention program was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia and Educational Planning and Research Division (EPRD), Ministry of Education Malaysia. It was funded by the Ministry of Health Malaysia.

    MeSH terms: Child; Female; Health Education*; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; School Health Services*; Program Evaluation; Cluster Analysis; Overweight/therapy
  11. Elegbede IO, Al Jufaili SM, Jolaosho TL, Tesleem B, Adekunle AF, Modupe OO, et al.
    One Health, 2025 Jun;20:100972.
    PMID: 39906161 DOI: 10.1016/j.onehlt.2025.100972
    Health considerations are seldom integrated into non-state voluntary sustainability certification standards, despite industrial fishing being one of the most hazardous occupations, often resulting in significant health risks for fishers. These challenges not only affect individual fishers but also have broader implications for the socio-ecological sustainability of fisheries. This study explores the effects of certification programs on industrial fishing activities and their health and safety dimensions within a socio-ecological framework, focusing on the Atlantic shrimp fishery in Nigeria. A mixed-methods approach was employed, combining qualitative and quantitative data collection techniques. Data were gathered from experienced employees of Friend of the Sea (FOS) certified and non-certified (Business-as-Usual, BAU) industrial fisheries through questionnaires, complemented by semi-structured interviews with selected key informants. The study examines the relationships between demographic variables, health-related indicators, and certification program participation using multivariate analyses, including Chi-square and standard logistic regression models. The findings revealed that fishers participating in the FOS certification program reported better health conditions, lower risks, and higher insurance coverage levels than their BAU counterparts. Certified fishers had greater access to sick leave and annual days off and were more likely to be physically fit for work. Conversely, fishers in the BAU group faced significantly higher health risks and casualty rates during fishing operations. These results underscore the critical role of health-focused certification programs, such as FOS, in improving the well-being of fishers, thereby enhancing the socio-ecological sustainability of Nigeria's shrimp fishing industry. The study highlights the importance of integrating health considerations into sustainability certification standards. By prioritizing fisher's safety and well-being, such programs contribute to the sustainable management of fisheries resources and environmental protection, aligning with the principles of the One Health framework.
  12. Nguyen PNT, Heininger U, Muloiwa R, von König CHW, Hozbor D, Ong-Lim A, et al.
    IJID Reg, 2025 Mar;14:100559.
    PMID: 39906191 DOI: 10.1016/j.ijregi.2024.100559
    The Global Pertussis Initiative met in March 2024 to discuss the burden of pertussis and prevention efforts in six Southeast Asian countries: Cambodia, Indonesia, Malaysia, Singapore, Thailand, and Vietnam. Except for Cambodia, pertussis is a notifiable disease; data accuracy varies within and between countries. Most cases in the region are diagnosed based on clinical suspicion. Whole-cell and acellular pertussis combination vaccines are available, but the composition differs between countries. Immunization against pertussis is well-established, but policies regarding boosting vary. Vaccination in pregnancy represents a still-neglected opportunity to protect infants. The Global Pertussis Initiative recommends enacting vaccination in pregnancy in countries without and increasing coverage in countries with policies already in place. There is a need to correct the misperception that pertussis affects children exclusively and that childhood vaccines provide lifelong protection. Education is key to widespread understanding of the threat of pertussis and removing barriers to vaccination in Southeast Asia.
  13. Chun Heng L, Muhd Nor NI
    Cureus, 2025 Jan;17(1):e76946.
    PMID: 39906435 DOI: 10.7759/cureus.76946
    Cytomegalovirus (CMV) is a double-stranded (dsDNA) virus of the herpesvirus family. Serological tests reveal signs of previous exposure to it in 40% to 100% of the general population. CMV anterior uveitis (AU) is the most common form of ocular manifestation of CMV in immunocompetent individuals. Clinically, it manifests mainly as anterior chamber (AC) inflammation, iris atrophy, and elevated intraocular pressure (IOP). In this study, we presented four cases of CMV AU with high IOP requiring different treatment modalities to control the IOP.  All patients underwent AC paracentesis, and the aqueous sample sent for polymerase chain reaction (PCR) showed CMV DNA. They were treated with ganciclovir ophthalmic gel 0.15% for the infection. For IOP control, patients underwent different surgeries, namely microinvasive glaucoma surgery (MIGS) with XEN implant, augmented trabeculectomy (AT), glaucoma drainage device implantation (GDI), and transscleral cyclophotocoagulation (TSCPC). Patients were then followed up for a period ranging from six months to three years post-intervention to monitor for evidence of recurrence, IOP control, number of topical antiglaucoma medications required, and progression of glaucoma as evidenced by optical coherence tomography (OCT) retina nerve fiber layer (RNFL) and Humphrey visual field (HVF).
  14. Mohd Shumiri MAI, Mohd Najib AS, Putra AEE, Fadil NA
    Sci Technol Adv Mater, 2025;26(1):2451017.
    PMID: 39906547 DOI: 10.1080/14686996.2025.2451017
    Traditionally employed in alloy corrosion studies, dealloying has evolved into a versatile technique for fabricating advanced porous materials. The unique architecture of interconnected pore channels and continuous metal ligaments endows dealloyed materials with high surface-to-volume ratio, excellent electron conductivity, efficient mass transport and remarkable catalytic activity, positioning them at the forefront of nanomaterial applications with significant potential. However, reproducible synthesis of these structures remains challenging due to limitations in conventional dealloying techniques. Herein, this review attempts to consolidate recent progress in electrochemical and chemical dealloying methods for nanoporous anodes in energy storage and conversion applications. We begin by elucidating the fundamental mechanisms driving dealloying and evaluate key factors influencing dealloying conditions. Through a review of current research, we identify critical properties of dealloyed nanoporous anodes that warrant further investigation. Applications of these materials as anodes in metal-ion batteries, supercapacitors, water splitting and photocatalyst are discussed. Lastly, we address ongoing challenges in this field and propose perspectives on promising research directions. This review aims to inspire new pathways and foster the development of efficient dealloyed porous anodes for sustainable energy technologies.
  15. Liu W, Md Ishak SM, Yahaya MF
    Heliyon, 2025 Jan 30;11(2):e41968.
    PMID: 39906840 DOI: 10.1016/j.heliyon.2025.e41968
    Career transitions often lead young migrants to relocate, necessitating frequent disposal of furniture. Therefore, furniture rental offers a practical solution to this recurring issue. There is a need to establish sustainable furniture rentals to accommodate the unique needs of young migrants. The researchers used a 'Literature Review Synthesis Process' to analyse and integrate the collected information. The aim was to discover optimal solutions to address the challenges of furniture rental for young migrants, ensuring they no longer need to concern themselves with furniture disposal during relocation. The findings indicate that adopting sustainable materials is a strategy to fulfil the criteria of sustainability, cost-effectiveness, transportability, hygiene, dependability, aesthetic appeal, and damage recompense garners with significant approval.
  16. Zakaria N, Han H, Khalil Y, Ashworth M, Yu Q, Flower KC
    Pest Manag Sci, 2025 Feb 05.
    PMID: 39907002 DOI: 10.1002/ps.8690
    BACKGROUND: The first case of glyphosate resistance was reported in a capeweed population from Western Australia in our previous study. This current study investigates the resistance mechanisms in the population.

    RESULTS: Target-site EPSPS gene sequencing revealed two partial sequences of the EPSPS transcripts (1001 bp and 998 bp), and the full-length sequence (1551 bp) containing the 1001-bp transcript was cloned as it was found in the resistant plants. A known resistance-endowing target-site mutation in the 1551-bp transcript was identified in the resistant plants, resulting in the Pro-106-Ser substitution. The subpopulation derived from these mutant plants exhibited >10-fold resistance to glyphosate compared to the susceptible population. Additionally, the EPSPS gene (1551 bp) was constitutively expressed at a higher level (4.3-fold) in the resistant than in the susceptible populations. However, 14C-glyphosate foliar uptake was similar with no visual difference in 14C-glyphosate translocation from leaves to other parts of a plant, between the resistant and susceptible population.

    CONCLUSION: Glyphosate resistance in the studied population is associated with both a target-site mutation (Pro-106-Ser) and increased EPSPS gene expression. © 2025 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

  17. Venugopal V, Ismail M, Mohamed MNA, Chinna K, Jalaludin MY, Su TT, et al.
    J Adolesc, 2025 Feb 05.
    PMID: 39907033 DOI: 10.1002/jad.12479
    INTRODUCTION: This study investigated the longitudinal relationship between self-reported physical activity and national examination results among adolescents in an upper-middle-income country.

    METHODS: This study engaged in a secondary data analysis derived from a closed prospective cohort consisting of 579 students, who were recruited at the age of 13 in 2012 and followed up at ages 15 (2014) and 17 (2016) as part of the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study, which was conducted across three states in Peninsula Malaysia. Physical activity levels were evaluated using the Physical Activity Questionnaire, and outcomes were assessed based on the National-Based Examinations at ages 15 (Form 3, Year 9) and 17 (Form 5, Year 11) in Malaysia. A multivariate ordinal regression employing complex sample analysis was applied to ascertain the relationship between physical activity and national examination results.

    RESULTS: In Form 3 (Year 9), those physically active performed better in Malay Language, English Language, Mathematics and Science. Those physically active in Form 5 (Year 11), performed better in Modern Mathematics, Chemistry, and Principles of Accounting. Longitudinally, there was an increase in the overall percentage of those who were overweight and obese and an increase in those with suboptimal dietary and iron intake.

    CONCLUSIONS: This study has shown that those physically active students fared better in several subjects in the national-based examinations. Suitable physical activity intervention should be tailored accordingly to support adolescents' optimum achievement in academia.

  18. Ouyang M, González F, Montalbano M, Pruski A, Jan S, Wang X, et al.
    Cerebrovasc Dis, 2025;54(1):96-104.
    PMID: 38442704 DOI: 10.1159/000538136
    INTRODUCTION: The ongoing OPTIMISTmain study, an international, multicenter, stepped-wedge cluster randomized trial, aims to determine effectiveness and safety of low-intensity versus standard monitoring in thrombolysis-treated patients with mild-to-moderate acute ischemic stroke (AIS). An embedded process evaluation explored integration and impact of the intervention on care processes at participating US sites.

    METHODS: A mixed-methods approach with quantitative and qualitative data was collected between September 2021 and November 2022. Implementer surveys were undertaken at pre- and post-intervention phases to understand the perceptions of low-intensity monitoring strategy. A sample of stroke care nurses were invited to participate in semi-structured interviews at an early stage of post-intervention. Qualitative data were analyzed deductively using the normalization process theory; quantitative data were tabulated.

    RESULTS: Interviews with 21 nurses at 8 hospitals have shown low-intensity monitoring was well accepted as there were less time constraints and reduced workload for each patient. There were initial safety concerns over missing deteriorating patients and difficulties in changing established routines. Proper training, education, and communication, and changing the habits and culture of care, were key elements to successfully adopting the new monitoring care into routine practice. Similar results were found in the post-intervention survey (42 nurses from 13 hospitals). Nurses reported time being freed up to provide patient education (56%), daily living care (50%), early mobilization (26%), mood/cognition assessment (44%), and other aspects (i.e., communication, family support).

    CONCLUSIONS: Low-intensity monitoring for patients with mild-to-moderate AIS, facilitated by appropriate education and organizational support, appears feasible and acceptable at US hospitals.

    MeSH terms: Attitude of Health Personnel; Humans; Infusions, Intravenous; Interviews as Topic; Health Knowledge, Attitudes, Practice; Nursing Staff, Hospital; Tissue Plasminogen Activator/administration & dosage; Predictive Value of Tests; Recombinant Proteins/administration & dosage; Time Factors; United States; Treatment Outcome; Drug Monitoring; Process Assessment (Health Care)
  19. Fu Q, Huang R, Li F, Beardall J, Hutchins DA, Liu J, et al.
    Plant Cell Environ, 2025 Mar;48(3):1829-1841.
    PMID: 39494748 DOI: 10.1111/pce.15262
    The marine microalga Emiliania huxleyi is widely distributed in the surface oceans and is prone to infection by coccolithoviruses that can terminate its blooms. However, little is known about how global change factors like solar UV radiation (UVR) and ocean warming affect the host-virus interaction. We grew the microalga at 2 temperature levels with or without the virus in the presence or absence of UVR and investigated the physiological and transcriptional responses. We showed that viral infection noticeably reduced photosynthesis and growth of the alga but was less harmful to its physiology under conditions where UVR influenced viral DNA expression. In the virus-infected cells, the combination of UVR and warming (+4°C) led to a 13-fold increase in photosynthetic carbon fixation rate, with warming alone contributing a change of about 5-7-fold. This was attributed to upregulated expression of genes related to carboxylation and light-harvesting proteins under the influence of UVR, and to warming-reduced infectivity. In the absence of UVR, viral infection downregulated the metabolic pathways of photosynthesis and fatty acid degradation. Our results suggest that solar UV exposure in a warming ocean can reduce the severity of viral attack on this ecologically important microalga, potentially prolonging its blooms.
    MeSH terms: Ultraviolet Rays*; Phycodnaviridae/physiology; Global Warming; Microalgae/physiology; Microalgae/radiation effects; Microalgae/virology
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