Displaying publications 1 - 20 of 30 in total

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  1. Basri NI, Soon CH, Ali A, Abdul Ghani NA, Zainuddin AA
    Horm Mol Biol Clin Investig, 2021 Mar 08;42(3):325-328.
    PMID: 33675193 DOI: 10.1515/hmbci-2021-0001
    OBJECTIVES: We compared cases of phenotypic female patients who presented with male karyotype and underwent prophylactic gonadectomy.

    CASE PRESENTATION: Five patients with female phenotypes presented in early adulthood with primary amenorrhoea with varying degrees of puberty. One was tall with breast development. Another was very short with clitoromegaly and multiple co-morbidities. The other three had no secondary sexual characteristics. They were examined, after which hormonal profile, karyotyping, ultrasound examination and magnetic resonance imaging were done to assess the site of gonads. Gonadectomy was performed once their 46 XY karyotype was confirmed. Results of histopathological examination of their gonads ranged from dysgenetic gonads to having testicular tissues and malignancy.

    CONCLUSION: Female patients with 46 XY karyotypes require prophylactic gonadectomy performed at different timings depending on diagnosis due to the malignancy risk. Pre-operative assessment is essential to locate the gonads prior to surgery.

  2. Ng BK, Lim PS, Shafiee MN, Ghani NA, Ismail NA, Omar MH, et al.
    Biomed Res Int, 2013;2013:587438.
    PMID: 24073412 DOI: 10.1155/2013/587438
    Objective. To determine the diagnostic accuracy of placental alpha microglobulin-1 assay and standard diagnostic methods for detecting rupture of membrane. Study Design. Prospective diagnostic study, between June 2011 to November 2011 at a tertiary centre. Initial evaluation included both the standard diagnostic methods for rupture of membranes and placental alpha microglobulin-1 immunoassay. The actual rupture of membranes was diagnosed on review of the medical records after delivery (absence of membrane or a positive pad chart). Main Outcome Measures. Placental alpha microglobulin-1 immunoassay and standard diagnostic methods for diagnosis of rupture of membrane. Results. A total of 211 patients were recruited. At initial presentation, 187 patients (88.6%) had ruptured membranes, while 24 patients (11.4%) had intact membranes. Placental alpha microglobulin-1 immunoassay confirmed rupture of membranes at initial presentation with a sensitivity of 95.7% (179 of 187), specificity of 100% (24 of 24), positive predictive value of 100% (179 of 179), and negative predictive value of 75.0% (24 of 32). By comparison, the conventional standard diagnostic methods had a sensitivity of 78.1% (146 of 187), specificity of 100% (24 of 24), positive predictive value of 100% (146 of 146), and negative predictive value of 36.9% (24 of 65) in diagnosing rupture of membrane. Conclusion. Placental alpha-microglobulin-1 immunoassay is a rapid and accurate method for confirming the diagnosis of rupture of membrane. It was superior to conventional standard diagnostic methods (pooling, nitrazine, and ferning), the nitrazine test alone or fern test alone.
  3. Azman SS, Yazid MD, Abdul Ghani NA, Raja Sabudin RZA, Abdul Rahman MR, Sulaiman N
    Artif Cells Nanomed Biotechnol, 2023 Dec;51(1):408-416.
    PMID: 37584645 DOI: 10.1080/21691401.2023.2245456
    Endothelial dysfunction initiates the pathogenesis of a myriad of cardiovascular diseases, yet the precise underlying mechanisms remain unclear. Current model utilises mechanical denudation of arteries resulting in an arterial-injury model with onset of intimal hyperplasia (IH). Our study shows that 5 min enzymatic denudation of human umbilical artery (hUA) lumen at 37 °C efficiently denudes hUA while maintaining vessel integrity without significantly increase intima-media thickness after 7 days in culture. This ex-vivo model will be a valuable tool in understanding the mechanism of re-endothelialization prior to smooth muscle cells (SMC) activation thus placating IH at an early stage.
  4. Subramaniam P, Thillainathan P, Mat Ghani NA, Sharma S
    PLoS One, 2023;18(10):e0291620.
    PMID: 37796820 DOI: 10.1371/journal.pone.0291620
    The Life Story Book has been commonly used in promoting person-centred care in older adults, especially for persons with dementia. This involves collecting the life stories and memories of the person living with dementia and compiling them into a book or folder, which is used by staff or family to assist the person recall these memories. Evidence on the use, benefits and influences of the Life Story Book in dementia care is limited. This systematic literature review aimed to collect past reviews and provide a thorough overview of the use, benefits, and impact of the Life Story Book for the person with dementia, the relatives, family, and caregivers. The electronic databases PubMed, Scopus, Science Direct and Web of Science as well as grey literature through Google Scholar were searched to select the relevant studies. Seven studies that meet the inclusion criteria were selected and data synthesised. Findings revealed that the use of the Life Story Book has no specific guidelines and has been described with numerous characteristics and varied implementation methods. The Life Story Book intervention is found to provide positive outcomes for the person with dementia and the carers involved. Six out of the seven studies reported that Life Story Book enhanced communication between persons with dementia, relatives, care staff, and residents. The review extends the current evidence on the usage of the Life Story Book in dementia care and confirms that the use of life stories leads to better care in various settings. However, more research is needed to reveal the potential of the Life Story Book in enhancing communication. Guidelines and training are also required to make the best use of the Life Story Book.
  5. Ghani NA, Ahmad R, Rahman RA, Yunus MR, Putra SP, Ramli R
    J Maxillofac Oral Surg, 2009 Dec;8(4):316-9.
    PMID: 23139535 DOI: 10.1007/s12663-009-0077-9
    Ranula is a mucous extravasation cyst which occurs as a result of trauma or obstruction of the sublingual or minor salivary gland or the duct itself.
  6. Abdul Ghani NA, Abdul Nasir NA, Lambuk L, Sadikan MZ, Agarwal R, Ramli N
    Graefes Arch Clin Exp Ophthalmol, 2023 Jun;261(6):1587-1596.
    PMID: 36622408 DOI: 10.1007/s00417-022-05965-3
    PURPOSE: Angiogenesis in diabetic retinopathy (DR) is associated with increased retinal expression of angiopoietin-2 (Ang-2) and protein kinase C (PKC). Tocotrienol-rich fraction (TRF) has been shown to reduce the expression vascular endothelial growth factor (VEGF) in several experimental models. However, its effect against other angiogenic markers such as Ang-2 and PKC in rat model of diabetes remains unknown. Therefore, we investigated the effect of TRF on the retinal vascular changes and Ang-2 and PKC expressions in rats with streptozotocin (STZ)-induced DR.

    METHODS: Sprague-Dawley rats were divided into normal control rats (N) which received vehicle, and diabetic rats which either received vehicle (DV) or 100 mg/kg of TRF (DT). Diabetes was induced with intraperitoneal injection of STZ (60 mg/kg body weight). Treatments were given orally, once daily, for 12 weeks after confirmation of hyperglycaemia. Fundus photographs were captured at baseline, 6- and 12-week post-STZ injection and average diameter of retinal veins and arteries were measured. At 12-week post-STZ injection, rats were euthanised, and retinae were collected for measurement of Ang-2 and PKC gene and protein expressions.

    RESULTS: Retinal venous and arterial diameters were significantly greater in DV compared to DT at week 12 post-STZ injection (p 

  7. Abdul Ghani NA, Mohd Abdullah AAB, Abdul Hamid S, Yuhana MY, Ramli N
    Eur J Ophthalmol, 2020 Oct 19.
    PMID: 33070639 DOI: 10.1177/1120672120965499
    BACKGROUND: Deep cerebral venous sinus thrombosis is a reversible yet potentially serious thromboembolic event. A number of reports suggest a relationship between long-haul flights and thromboembolic events, mainly deep venous thrombosis (DVT) and pulmonary embolism (PE). It is rarely reported to cause deep cerebral venous sinus thrombosis. We report a case of a bilateral papilledema after long-haul flight secondary to deep cerebral venous sinus thrombosis with subsequent complete recovery post corticosteroid and anticoagulant therapy.

    CASE: A case of a 21-year-old woman with no known medical illness who presented with gradual painless bilateral visual loss is described. She had a history of travelling on a long-haul flight 3 weeks prior to presentation. Examination showed presence of bilateral papilloedema, no vitritis, choroiditis and retinitis. Blood investigations showed raised international normalised ratio (INR). Otherwise, workup for infectious causes of optic disc swelling, connective tissue disease screening were normal. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) of the brain showed loss of flow signal in the right transverse sinus and the left sigmoid sinus. Blood workup for preexisting hypercoagulable state was normal. She was diagnosed with deep cerebral venous sinus thrombosis and showed complete recovery with oral corticosteroid and anticoagulant therapy.

    CONCLUSION: Deep cerebral venous sinus thrombosis is a potentially serious consequence of long-haul flights. A high index of suspicion along with radiological techniques is needed for early detection and initiation of anticoagulation for this reversible condition.

  8. Saibul N, Shariff ZM, Lin KG, Kandiah M, Ghani NA, Rahman HA
    Asia Pac J Clin Nutr, 2009;18(3):412-22.
    PMID: 19786390
    This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.
  9. Khalid R, Nawawi MK, Kawsar LA, Ghani NA, Kamil AA, Mustafa A
    PLoS One, 2013;8(4):e58402.
    PMID: 23560037 DOI: 10.1371/journal.pone.0058402
    M/G/C/C state dependent queuing networks consider service rates as a function of the number of residing entities (e.g., pedestrians, vehicles, and products). However, modeling such dynamic rates is not supported in modern Discrete Simulation System (DES) software. We designed an approach to cater this limitation and used it to construct the M/G/C/C state-dependent queuing model in Arena software. Using the model, we have evaluated and analyzed the impacts of various arrival rates to the throughput, the blocking probability, the expected service time and the expected number of entities in a complex network topology. Results indicated that there is a range of arrival rates for each network where the simulation results fluctuate drastically across replications and this causes the simulation results and analytical results exhibit discrepancies. Detail results that show how tally the simulation results and the analytical results in both abstract and graphical forms and some scientific justifications for these have been documented and discussed.
  10. Shafiee MN, Malik DA, Yunos RI, Atiomo W, Omar MH, Ghani NA, et al.
    Gynecol Endocrinol, 2015 Apr;31(4):286-90.
    PMID: 25495168 DOI: 10.3109/09513590.2014.989982
    The aim of this proof-of-concept study was to determine the effects of three-month Metformin therapy on the expression of tumor-regulatory genes (p53, cyclin D2 and BCL-2) in the endometrium of women with polycystic ovary syndrome (PCOS). A total of 40 women, aged between 21 and 45 years with PCOS (Rotterdam criteria) were recruited. The participants were assessed at pre- and 3-month-post-Metformin therapy for the menstrual regularities, weight reduction, Ferriman Galway scores, fasting blood glucose (FBG), total cholesterol, LDL, HDL and p53, BCL-2 and cyclin D2 gene expression. Five participants conceived spontaneously after the initial recruitment. Majority (68%) resumed regular menstrual cycles after Metformin. There were significant reduction in BMI (p = 0.001), weight (p = 0.001) and Ferriman Galway scores (p = 0.001). A significant improvement was seen in mean FBG (p = 0.002), total cholesterol (p = 0.001), LDL (p = 0.003) and HDL cholesterol levels (p = 0.015). Tumor suppressor gene (p53) was significantly up-regulated after Metformin (10 out of 14 women), with p value 0.016. BCL-2 and cyclin D2 (oncogenes) were slightly up-regulated without significant difference (p = 0.119 and 0.155, respectively). In conclusion, Metformin therapy improved clinical and metabolic parameters in women with PCOS and up-regulated p53 tumor suppressor gene significantly. Further studies are however required to independently validate our findings.
  11. Abdul Karim AK, Shafiee MN, Abd Aziz NH, Omar MH, Abdul Ghani NA, Lim PS, et al.
    Gynecol Endocrinol, 2019 Jan;35(1):10-16.
    PMID: 30044157 DOI: 10.1080/09513590.2018.1490404
    Endometriosis is a benign, chronic inflammatory condition characterized by the presence and growth of endometrial implants outside the uterine cavity. The cause of endometriosis is multifactorial. It is due to the diversity of hypothesis and plausibility of hormonal alterations which could play a major role. Evidence has shown that progesterone resistance is a key factor for endometriosis sufferers. Medical therapy can avoid surgical intervention, which may lead to a reduced in ovarian reserve, and its effects of earlier menopause and reduced fecundity. Progesterone receptor isoform has provided new insight as the potential treatment. Progestin, anti-progestin and selective progesterone receptor modulators usage, which target these receptors, could avoid hypo-estrogenic side effects, which can be debilitating. Numerous types of these medications have been used on and off labeled to treat endometriosis with varying success. This review aims to consolidate series of clinical trials using progestins in endometriosis.
  12. Zakaria S, Mat-Husain SZ, Ying-Hwey K, Xin-Kai K, Mohd-Badawi A, Abd-Ghani NA, et al.
    Iran J Basic Med Sci, 2017 Dec;20(12):1360-1367.
    PMID: 29238472 DOI: 10.22038/IJBMS.2017.9610
    Objectives: Alcohol consumption induces oxidative stress on bone, which in turn increases the risk of osteoporosis. This study determined the effects of vitamin E on bone strength and bone mineral content in alcohol-induced osteoporotic rats.

    Materials and Methods: Three months old Sprague Dawley male rats were randomly divided into 5 groups: (I) control group; (II) alcohol (3g/kg) + normal saline; (III) alcohol (3g/kg) + olive oil; (IV) alcohol (3g/kg) + alpha-tocopherol (60mg/kg) and (V) alcohol (3g/kg) + palm vitamin E (60mg/kg). The treatment lasted for three months. Following sacrifice, the right tibia was subjected to bone biomechanical test while the lumbar (fourth and fifth lumbar) and left tibia bones were harvested for bone mineral measurement.

    Results: Alcohol caused reduction in bone biomechanical parameters (maximum force, ultimate stress, yield stress and Young's modulus) and bone minerals (bone calcium and magnesium) compared to control group (P<0.05). Palm vitamin E was able to improve bone biomechanical parameters by increasing the maximum force, ultimate stress and Young's modulus (P<0.05) while alpha-tocopherol was not able to. Both alpha-tocopherol and palm vitamin E were able to significantly increase tibia calcium and magnesium content while only alpha-tocopherol caused significant increase in lumbar calcium content (P<0.05).

    Conclusion: Both palm vitamin E and alpha-tocopherol improved bone mineral content which was reduced by alcohol. However, only palm vitamin E was able to improve bone strength in alcohol treated rats.

  13. Teik CK, Basri NI, Abdul Karim AK, Azrai Abu M, Ahmad MF, Abdul Ghani NA, et al.
    Arch Iran Med, 2019 06 01;22(6):340-343.
    PMID: 31356101
    Cerebral arteriovenous malformation (AVM) is a rare entity with an estimated prevalence of 0.01-0.05% in the general population. We reviewed hospital obstetric records during 2010-2017 and reported a case series of six patients with cerebral AVM in pregnancy, of which five patients had successful pregnancy, and one maternal mortality.
  14. Basri NI, Abd Ghani NA, Mahdy ZA, Abdul Manaf MR, Mohamed Ismail NA
    Horm Mol Biol Clin Investig, 2020 Apr 17;41(3).
    PMID: 32304300 DOI: 10.1515/hmbci-2019-0069
    Background The objective was to compare the effectiveness and tolerability of mefenamic acid and celecoxib in women with primary dysmenorrhea (PD) and to compare the quality of life of study participants pre- and post-treatment. Materials and methods This was a randomized crossover clinical trial conducted among sexually inactive female adults aged 18-25 years with PD. Participants were asked to rate their pain score and answer a validated quality of life questionnaire (EQ-5D-3L) before and after consumption of each medication in two menstrual cycles. The effectiveness of celecoxib and mefenamic acid in treating PD was compared with regard to reduction in pain score and the need for medical leave and rescue therapy. Drug tolerability was determined by comparing the occurrence of side effects of both drugs. Quality of life scores pre- and post-intervention were measured and compared. Results Mefenamic acid had a comparable effect to celecoxib in relieving symptoms of PD. Both drugs were equally tolerable and showed similar impacts on quality of life. Conclusions This study demonstrated that mefenamic acid and celecoxib had similar effectiveness in improving pain score and quality of life in women with PD.
  15. Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA
    J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
    PMID: 17441895
    We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.
  16. Quraishi KS, Bustam MA, Krishnan S, Aminuddin NF, Azeezah N, Ghani NA, et al.
    Chemosphere, 2017 Oct;184:642-651.
    PMID: 28624742 DOI: 10.1016/j.chemosphere.2017.06.037
    A promising method of Carbon dioxide (CO2) valorization is to use green microalgae photosynthesis to process biofuel. Two Phase Partitioning Bioreactors (TPPBR) offer the possibility to use non-aqueous phase liquids (NAPL) to enhance CO2 solubility; thus making CO2 available to maximize algae growth. This requires relatively less toxic hydrophobic Ionic Liquids (ILs) that comprise a new class of ionic compounds with remarkable physicochemical properties and thus qualifies them as NAPL candidates. This paper concerns the synthesis of ILs with octyl and butyl chains as well as different cations containing aromatic (imidazolium, pyridinium) and non-aromatic (piperidinum, pyrrolidinium) rings for CO2 absorption studies. The authors measured their respective toxicity levels on microalgae species, specifically, Scenedesmus quadricauda, Chlorella vulgaris and Botryococcus braunii. Results revealed that octyl-based ILs were more toxic than butyl-based analogues. Such was the case for bmim-PF6 at double saturation with an absorbance of 0.11, compared to Omim-PF6 at 0.17, bmim-NTf2 at 0.02, and Omim-NTf2 at 0.14, respectively. CO2 uptake results for ILs bearing octyl-based chains compared to the butyl analog were 54% (nCO2/nIL) (i.e., moles of CO2 moles of IL) and 38% (nCO2/nIL), respectively. Conclusively, 1-butyl-1-methylpiperidinium absorbed 13% (nCO2/nIL) and appeared the least toxic, having an absorbance of 0.25 at 688 nm (double saturation at 7 d) compared to 1-butyl-3-methylimidazolium, which showed the highest toxicity with zero absorbance. Accordingly, these findings suggest that 1-butyl-1-methylpiperidinium is capable of transporting CO2 to a system containing green microalgae without causing significant harm; thus allowing its use in TPPBR technology.
  17. Rahman K, Ghani NA, Kamil AA, Mustafa A, Kabir Chowdhury MA
    PLoS One, 2013;8(5):e63503.
    PMID: 23691055 DOI: 10.1371/journal.pone.0063503
    Pedestrian movements are the consequence of several complex and stochastic facts. The modelling of pedestrian movements and the ability to predict the travel time are useful for evaluating the performance of a pedestrian facility. However, only a few studies can be found that incorporate the design of the facility, local pedestrian body dimensions, the delay experienced by the pedestrians, and level of service to the pedestrian movements. In this paper, a queuing based analytical model is developed as a function of relevant determinants and functional factors to predict the travel time on pedestrian facilities. The model can be used to assess the overall serving rate or performance of a facility layout and correlate it to the level of service that is possible to provide the pedestrians. It has also the ability to provide a clear suggestion on the designing and sizing of pedestrian facilities. The model is empirically validated and is found to be a robust tool to understand how well a particular walking facility makes possible comfort and convenient pedestrian movements. The sensitivity analysis is also performed to see the impact of some crucial parameters of the developed model on the performance of pedestrian facilities.
  18. Md Ghani NA, Liong CY, Jemain AA
    Forensic Sci Int, 2010 May 20;198(1-3):143-9.
    PMID: 20211535 DOI: 10.1016/j.forsciint.2010.02.011
    The task of identifying firearms from forensic ballistics specimens is exacting in crime investigation since the last two decades. Every firearm, regardless of its size, make and model, has its own unique 'fingerprint'. These fingerprints transfer when a firearm is fired to the fired bullet and cartridge case. The components that are involved in producing these unique characteristics are the firing chamber, breech face, firing pin, ejector, extractor and the rifling of the barrel. These unique characteristics are the critical features in identifying firearms. It allows investigators to decide on which particular firearm that has fired the bullet. Traditionally the comparison of ballistic evidence has been a tedious and time-consuming process requiring highly skilled examiners. Therefore, the main objective of this study is the extraction and identification of suitable features from firing pin impression of cartridge case images for firearm recognition. Some previous studies have shown that firing pin impression of cartridge case is one of the most important characteristics used for identifying an individual firearm. In this study, data are gathered using 747 cartridge case images captured from five different pistols of type 9mm Parabellum Vektor SP1, made in South Africa. All the images of the cartridge cases are then segmented into three regions, forming three different set of images, i.e. firing pin impression image, centre of firing pin impression image and ring of firing pin impression image. Then geometric moments up to the sixth order were generated from each part of the images to form a set of numerical features. These 48 features were found to be significantly different using the MANOVA test. This high dimension of features is then reduced into only 11 significant features using correlation analysis. Classification results using cross-validation under discriminant analysis show that 96.7% of the images were classified correctly. These results demonstrate the value of geometric moments technique for producing a set of numerical features, based on which the identification of firearms are made.
  19. Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA
    J Obstet Gynaecol Res, 2009 Feb;35(1):48-54.
    PMID: 19215547 DOI: 10.1111/j.1447-0756.2008.00829.x
    To compare the efficacy of a single dose of 100 microg intramuscular carbetocin to a single dose of intramuscular syntometrine (0.5 mg ergometrine and 5IU oxytocin), in preventing post-partum hemorrhage (PPH) in high risk patients following vaginal delivery.
  20. Rayung M, Ghani NA, Hasanudin N
    RSC Adv, 2024 Mar 14;14(13):9273-9299.
    PMID: 38505386 DOI: 10.1039/d3ra08684d
    The transition from conventional polyurethane (PU) to non isocyanate polyurethane (NIPU) is driven mainly by safety concerns, environmental considerations, and sustainability issues associated with the current PU technology. NIPU has emerged as a promising alternative, addressing limitations related to traditional PU production. There has been increasing interest in bio-based NIPU aligning with the aspiration for green materials and processes. One important biomass resource for the development of bio-based NIPU is vegetable oil, an abundant, renewable, and relatively low cost feedstock. As such, this review aims to provide insight into the progression of NIPU derived from vegetable oils. This article highlights the synthetic and green approach to NIPU production, emphasizing the method involving the polyaddition reaction of cyclic carbonates and amines. The review includes case studies on vegetable oil-based NIPU and perspectives on their properties. Further, discussions on the potential applications and commercial importance of PU and NIPU are included. Finally, we offer perspectives on possible research directions and the future prospects of NIPU, contributing to the ongoing evolution of PU technology.
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