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Fulltext Nursing students' and faculty members' experiences of online education during COVID-19 across Southeast Asia: A Photovoice study

Kunaviktikul W, Ang E, Baridwan NS, Bernal AB, Dones LBP, Flores JL, et al.

Nurse Educ Today, 2022 Apr;111:105307.
PMID: 35217457 DOI: 10.1016/j.nedt.2022.105307

BACKGROUND: The COVID-19 pandemic has caused extraordinary disruptions to education systems globally, forcing a rapid switch from conventional to online education. Although some qualitative studies have been carried out exploring the online education experiences of nursing students and faculty members during the COVID-19 pandemic, to our knowledge, no study has used the Photovoice approach.
OBJECTIVES: To explore the experiences of nursing students and faculty members as related to online education during the COVID-19 pandemic.
DESIGN: A descriptive qualitative design using Photovoice was adopted.
SETTING: The study took place across five countries and one city in Southeast Asia (Indonesia, Malaysia, the Philippines, Thailand, Vietnam, and Hong Kong).
PARTICIPANTS: Fifty-two nursing students and twenty-eight nursing faculty members who participated in online education during the COVID-19 pandemic.
METHODS: Each participant submitted one photo substantiated with written reflections. Data were analysed using thematic analysis. Ethical approval was obtained from institution-specific ethics boards.
RESULTS: Three themes and eleven sub-themes emerged from the data. The three main themes were: 1) Psychological roadblocks to online education; 2) Developing resilience despite adversities; and 3) Online education: What worked and what did not.
CONCLUSION: Through Photovoice, the reflections revealed that nursing students and faculty members were generally overwhelmed with the online education experience. At the same time, participants were satisfied with the flexibility and convenience, opportunities for professional and personal development and safety afforded by online education. However, concerns over academic integrity, practical skills and clinical competencies, engagement and participation, the duality of technology and social isolation out-shadowed the advantages. It is worthwhile to explore the concerns raised to enhance online education across the nursing curriculum.
Fulltext Salutogenesis and COVID-19 pandemic impacting nursing education across SEANERN affiliated universities: A multi-national study

Shorey S, Ang E, Baridwan NS, Bonito SR, Dones LBP, Flores JLA, et al.

Nurse Educ Today, 2022 Mar;110:105277.
PMID: 35101809 DOI: 10.1016/j.nedt.2022.105277

BACKGROUND: The COVID-19 pandemic has disrupted the lives of many. Particularly, nursing students experience greater stress as their normal curriculum is interrupted and some of them face the risk of being infected as frontline workers. Nursing faculty members may face similar struggles, in addition to developing teaching materials for online learning. Thus, it is important to examine the faculty members' and students' views on their ability to adapt during the pandemic to obtain a holistic view of how learning and training has been affected.
DESIGN: The descriptive cross-sectional quantitative design was used.
SETTINGS: Data were collected from Southeast and East Asian Nursing Education and Research Network (SEANERN) affiliated nursing institutions from January 2021 to August 2021.
PARTICIPANTS: A total of 1897 nursing students and 395 faculty members from SEANERN-affiliated nursing institutions in Cambodia, Hong Kong, Indonesia, Japan, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam were recruited for this study.
METHODS: Quantitative surveys were used to explore the satisfaction levels in education modalities, confidence levels, psychosocial well-being, sense of coherence and stress levels of nursing students and faculty members during the COVID-19 pandemic.
RESULTS: Participants were mostly satisfied with the new education modalities, although most students felt that their education was compromised. Both groups showed positive levels of psychosocial well-being, despite scoring low to medium on the sense of coherence scale and experiencing great stress. The participants' sense of coherence was positively correlated with their psychosocial well-being and negatively correlated with stress levels.
CONCLUSIONS: While the COVID-19 pandemic had negatively impacted the lives of nursing students and faculty members, most of them had a healthy level of psychosocial well-being. Having a strong sense of coherence was associated with better psychosocial health and lower stress levels. As such, it may be helpful to develop interventions aimed at improving the sense of coherence of nursing students and staff to help them manage stressors better.
Fulltext Hydroxychloroquine: Key therapeutic advances and emerging nanotechnological landscape for cancer mitigation

Low LE, Kong CK, Yap WH, Siva SP, Gan SH, Siew WS, et al.

Chem Biol Interact, 2023 Dec 01;386:110750.
PMID: 37839513 DOI: 10.1016/j.cbi.2023.110750

Hydroxychloroquine (HCQ) is a unique class of medications that has been widely utilized for the treatment of cancer. HCQ plays a dichotomous role by inhibiting autophagy induced by the tumor microenvironment (TME). Preclinical studies support the use of HCQ for anti-cancer therapy, especially in combination with conventional anti-cancer treatments since they sensitize tumor cells to drugs, potentiating the therapeutic activity. However, clinical evidence has suggested poor outcomes for HCQ due to various obstacles, including non-specific distribution, low aqueous solubility and low bioavailability at target sites, transport across tissue barriers, and retinal toxicity. These issues are addressable via the integration of HCQ with nanotechnology to produce HCQ-conjugated nanomedicines. This review aims to discuss the pharmacodynamic, pharmacokinetic and antitumor properties of HCQ. Furthermore, the antitumor performance of the nanoformulated HCQ is also reviewed thoroughly, aiming to serve as a guide for the HCQ-based enhanced treatment of cancers. The nanoencapsulation or nanoconjugation of HCQ with nanoassemblies appears to be a promising method for reducing the toxicity and improving the antitumor efficacy of HCQ.
Late clinical and magnetic resonance imaging follow up of Nipah virus infection

Lim CC, Lee WL, Leo YS, Lee KE, Chan KP, Ling AE, et al.

J Neurol Neurosurg Psychiatry, 2003 Jan;74(1):131-3.
PMID: 12486285

The Nipah virus is a newly identified paramyxovirus responsible for an outbreak of fatal encephalitis in Malaysia and Singapore. This paper reports the follow up clinical and magnetic resonance imaging findings in 22 affected subjects. Of 13 patients with encephalitis, one died, one was lost to follow up, and seven recovered. Among the four remaining patients, one had residual sixth nerve palsy, another suffered from severe clinical depression, and a third patient had evidence of retinal artery occlusion. One patient with delayed onset Horner syndrome had a single lesion in the cervical spinal cord. The brain magnetic resonance findings were stable or improved in nine patients over 18 months of follow up. Among a second group of nine asymptomatic seropositive abattoir workers, magnetic resonance examination in seven subjects revealed discrete small lesions in the brain; similar to those detected in encephalitis patients. These findings suggest that in addition to encephalitis, the newly discovered Nipah virus affects the spinal cord and the retina. Late clinical and radiological findings can occur in Nipah virus infections as with other paramyxoviruses.
Fulltext The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia

Chui PL, Chong MC, Abdullah KL, Ramoo V, Tang LY, Lee WL, et al.

Healthcare (Basel), 2021 Sep 24;9(10).
PMID: 34682939 DOI: 10.3390/healthcare9101259

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.
Fulltext Epinecidin-1, an Antimicrobial Peptide Derived From Grouper (Epinephelus coioides): Pharmacological Activities and Applications

Chee PY, Mang M, Lau ES, Tan LT, He YW, Lee WL, et al.

Front Microbiol, 2019;10:2631.
PMID: 31824449 DOI: 10.3389/fmicb.2019.02631

Epinecidin-1 is an antimicrobial peptide derived from the orange-spotted grouper (Epinephelus coioides). The mature epinecidin-1 peptide is predicted to have an amphipathic α-helical structure and a non-helical hydrophilic domain at the C-terminal RRRH. The majority of work studying the potential pharmacological activities of epinecidin-1, utilize synthesized epinecidin-1 (Epi-1), which is made up of 21 amino acids, from the amino acid sequence of 22-42 residues of Epi-1-GFIFHIIKGLFHAGKMIHGLV. The synthetized Epi-1 peptide has been demonstrated to possess diverse pharmacological activities, including antimicrobial, immunomodulatory, anticancer, and wound healing properties. It has also been utilized in different clinical and agricultural fields, including topical applications in wound healing therapy as well as the enhancement of fish immunity in aquaculture. Hence, the present work aims to consolidate the current knowledge and findings on the characteristics and pharmacological properties of epinecidin-1 and its potential applications.
Fulltext Angelicin-A Furocoumarin Compound With Vast Biological Potential

Mahendra CK, Tan LTH, Lee WL, Yap WH, Pusparajah P, Low LE, et al.

Front Pharmacol, 2020;11:366.
PMID: 32372949 DOI: 10.3389/fphar.2020.00366

Angelicin, a member of the furocoumarin group, is related to psoralen which is well known for its effectiveness in phototherapy. The furocoumarins as a group have been studied since the 1950s but only recently has angelicin begun to come into its own as the subject of several biological studies. Angelicin has demonstrated anti-cancer properties against multiple cell lines, exerting effects via both the intrinsic and extrinsic apoptotic pathways, and also demonstrated an ability to inhibit tubulin polymerization to a higher degree than psoralen. Besides that, angelicin too demonstrated anti-inflammatory activity in inflammatory-related respiratory and neurodegenerative ailments via the activation of NF-κB pathway. Angelicin also showed pro-osteogenesis and pro-chondrogenic effects on osteoblasts and pre-chondrocytes respectively. The elevated expression of pro-osteogenic and chondrogenic markers and activation of TGF-β/BMP, Wnt/β-catenin pathway confirms the positive effect of angelicin bone remodeling. Angelicin also increased the expression of estrogen receptor alpha (ERα) in osteogenesis. Other bioactivities, such as anti-viral and erythroid differentiating properties of angelicin, were also reported by several researchers with the latter even displaying an even greater aptitude as compared to the commonly prescribed drug, hydroxyurea, which is currently on the market. Apart from that, recently, a new application for angelicin against periodontitis had been studied, where reduction of bone loss was indirectly caused by its anti-microbial properties. All in all, angelicin appears to be a promising compound for further studies especially on its mechanism and application in therapies for a multitude of common and debilitating ailments such as sickle cell anaemia, osteoporosis, cancer, and neurodegeneration. Future research on the drug delivery of angelicin in cancer, inflammation and erythroid differentiation models would aid in improving the bioproperties of angelicin and efficacy of delivery to the targeted site. More in-depth studies of angelicin on bone remodeling, the pro-osteogenic effect of angelicin in various bone disease models and the anti-viral implications of angelicin in periodontitis should be researched. Finally, studies on the binding of angelicin toward regulatory genes, transcription factors, and receptors can be done through experimental research supplemented with molecular docking and molecular dynamics simulation.
Fulltext Novel sesquiterpene lactone analogues as potent anti-breast cancer agents

Nakagawa-Goto K, Chen JY, Cheng YT, Lee WL, Takeya M, Saito Y, et al.

Mol Oncol, 2016 06;10(6):921-37.
PMID: 27055598 DOI: 10.1016/j.molonc.2016.03.002

Triple-negative breast cancer (TNBC) is associated with high grade, metastatic phenotype, younger patient age, and poor prognosis. The discovery of an effective anti-TNBC agent has been a challenge in oncology. In this study, fifty-eight ester derivatives (DETDs) with a novel sesquiterpene dilactone skeleton were organically synthesized from a bioactive natural product deoxyelephantopin (DET). Among them, DETD-35 showed potent antiproliferative activities against a panel of breast cancer cell lines including TNBC cell line MDA-MB-231, without inhibiting normal mammary cells M10. DETD-35 exhibited a better effect than parental DET on inhibiting migration, invasion, and motility of MDA-MB-231 cells in a concentration-dependent manner. Comparative study of DETD-35, DET and chemotherapeutic drug paclitaxel (PTX) showed that PTX mainly caused a typical time-dependent G2/M cell-cycle arrest, while DETD-35 or DET treatment induced cell apoptosis. In vivo efficacy of DETD-35 was evaluated using a lung metastatic MDA-MB-231 xenograft mouse model. DETD-35 significantly suppressed metastatic pulmonary foci information along with the expression level of VEGF and COX-2 in SCID mice. DETD-35 also showed a synergistic antitumor effect with PTX in vitro and in vivo. This study suggests that the novel compound DETD-35 may have a potential to be further developed into a therapeutic or adjuvant agent for chemotherapy against metastatic TNBC.
The neurological manifestations of Nipah virus encephalitis, a novel paramyxovirus

Lee KE, Umapathi T, Tan CB, Tjia HT, Chua TS, Oh HM, et al.

Ann Neurol, 1999 Sep;46(3):428-32.
PMID: 10482278 DOI: 10.1002/1531-8249(199909)46:3<428::AID-ANA23>3.0.C

A novel Hendra-like paramyxovirus named Nipah virus (NiV) was the cause of an outbreak among workers from one abattoir who had contact with pigs. Two patients had only respiratory symptoms, while 9 patients had encephalitis, 7 of whom are described in this report. Neurological involvement was diverse and multifocal, including aseptic meningitis, diffuse encephalitis, and focal brainstem involvement. Cerebellar signs were relatively common. Magnetic resonance imaging scans of the brain showed scattered lesions. IgM antibodies against Hendra virus (HeV) were present in the serum of all patients. Two patients recovered completely. Five had residual deficits 8 weeks later.
Novel effect and the mechanistic insights of fruiting body extract of medicinal fungus Antrodia cinnamomea against T47D breast cancer

Shang KM, Su TH, Lee WL, Hsiao WW, Chiou CY, Ho BY, et al.

Phytomedicine, 2017 Jan 15;24:39-48.
PMID: 28160860 DOI: 10.1016/j.phymed.2016.11.006

INTRODUCTION: Tamoxifen, an anti-oestrogenic drug for estrogen receptor positive (ER+) breast cancer, was observed to stimulate tumor growth or drug resistance in patients. Antrodia cinnamomea (AC), a precious medicinal fungus has been traditionally used as a folk remedy for cancers in Asian countries. The objective of this study was to investigate the bioefficacy and the underlying molecular mechanisms of the AC fruiting bodies extracts (AC-3E) against human ER+ T47D breast cancer cells, and compare the effect with that of tamoxifen.
METHODS: Cell proliferation, migration, TUNEL assay, western blotting, time-lapse confocal microscopy analyses, chorioallantoic membrane assay, and a xenograft BALB/c nude mouse system were used in this study. Chemical fingerprinting of AC-3E was established using LC-MS.
RESULTS: AC-3E attenuated T47D breast cancer cell activity by deregulating the PI3K/Akt/mTOR signaling pathway and key cell-cycle mediators, and inducing apoptosis. AC-3E also effectively inhibited tube-like structures of endothelial cells, blood vessel branching and microvessel formation ex vivo and in vivo. Significant preventive and therapeutic effects against T47D mammary tumor growth of AC-3E was observed comparable or superior to tamoxifen treatment in xenograft BALB/c nude mice. Dehydroeburicoic acid (2) was characterized as the main chemical constituent in AC-3E against breast cancer.
CONCLUSION: This study suggests that AC-3E extracts can be employed as a double-barreled approach to treat human ER+ breast cancer by attacking both cancer cells and tumor-associated blood vessel cells.
Fulltext Targeting Membrane Lipid a Potential Cancer Cure?

Tan LT, Chan KG, Pusparajah P, Lee WL, Chuah LH, Khan TM, et al.

Front Pharmacol, 2017;8:12.
PMID: 28167913 DOI: 10.3389/fphar.2017.00012

Cancer mortality and morbidity is projected to increase significantly over the next few decades. Current chemotherapeutic strategies have significant limitations, and there is great interest in seeking novel therapies which are capable of specifically targeting cancer cells. Given that fundamental differences exist between the cellular membranes of healthy cells and tumor cells, novel therapies based on targeting membrane lipids in cancer cells is a promising approach that deserves attention in the field of anticancer drug development. Phosphatidylethanolamine (PE), a lipid membrane component which exists only in the inner leaflet of cell membrane under normal circumstances, has increased surface representation on the outer membrane of tumor cells with disrupted membrane asymmetry. PE thus represents a potential chemotherapeutic target as the higher exposure of PE on the membrane surface of cancer cells. This feature as well as a high degree of expression of PE on endothelial cells in tumor vasculature, makes PE an attractive molecular target for future cancer interventions. There have already been several small molecules and membrane-active peptides identified which bind specifically to the PE molecules on the cancer cell membrane, subsequently inducing membrane disruption leading to cell lysis. This approach opens up a new front in the battle against cancer, and is of particular interest as it may be a strategy that may be prove effective against tumors that respond poorly to current chemotherapeutic agents. We aim to highlight the evidence suggesting that PE is a strong candidate to be explored as a potential molecular target for membrane targeted novel anticancer therapy.
Bacterial extracellular vesicles in biofluids as potential diagnostic biomarkers

Su KY, Koh Kok JY, Chua YW, Ong SD, Ser HL, Pusparajah P, et al.

Expert Rev Mol Diagn, 2022 Dec;22(12):1057-1062.
PMID: 36629056 DOI: 10.1080/14737159.2022.2166403

INTRODUCTION: Extracellular vesicles (EVs) are spherical membrane-derived lipid bilayers released by cells. The human microbiota consists of trillions of microorganisms, with bacteria being the largest group secreting microbial EVs. The discovery of bacterial EVs (BEVs) has garnered interest among researchers as potential diagnostic markers, given that the microbiota is known to be associated with various diseases and EVs carry important macromolecular cargo for intercellular interaction.
AREAS COVERED: The differential bacterial composition identified from BEVs isolated from biofluids between patients and healthy controls may be valuable for detecting diseases. Therefore, BEVs may serve as novel diagnostic markers. Literature search on PubMed and Google Scholar databases was conducted. In this special report, we outline the commonly used approach for investigating BEVs in biofluids, the 16S ribosomal RNA gene sequencing of V3-V4 hypervariable regions, and the recent studies exploring the potential of BEVs as biomarkers for various diseases.
EXPERT OPINION: The emerging field of BEVs offers new possibilities for the diagnosis of various types of diseases, although there remain issues that need to be resolved in this research area to implement BEVs in clinical applications. Hence, it is important for future studies to take these challenges into consideration when investigating the diagnostic value of BEVs.
Fulltext Do Lipid-based Nanoparticles Hold Promise for Advancing the Clinical Translation of Anticancer Alkaloids?

Loh JS, Tan LKS, Lee WL, Ming LC, How CW, Foo JB, et al.

Cancers (Basel), 2021 Oct 25;13(21).
PMID: 34771511 DOI: 10.3390/cancers13215346

Since the commercialization of morphine in 1826, numerous alkaloids have been isolated and exploited effectively for the betterment of mankind, including cancer treatment. However, the commercialization of alkaloids as anticancer agents has generally been limited by serious side effects due to their lack of specificity to cancer cells, indiscriminate tissue distribution and toxic formulation excipients. Lipid-based nanoparticles represent the most effective drug delivery system concerning clinical translation owing to their unique, appealing characteristics for drug delivery. To the extent of our knowledge, this is the first review to compile in vitro and in vivo evidence of encapsulating anticancer alkaloids in lipid-based nanoparticles. Alkaloids encapsulated in lipid-based nanoparticles have generally displayed enhanced in vitro cytotoxicity and an improved in vivo efficacy and toxicity profile than free alkaloids in various cancers. Encapsulated alkaloids also demonstrated the ability to overcome multidrug resistance in vitro and in vivo. These findings support the broad application of lipid-based nanoparticles to encapsulate anticancer alkaloids and facilitate their clinical translation. The review then discusses several limitations of the studies analyzed, particularly the discrepancies in reporting the pharmacokinetics, biodistribution and toxicity data. Finally, we conclude with examples of clinically successful encapsulated alkaloids that have received regulatory approval and are undergoing clinical evaluation.
Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study

Ngow H, Teh LK, Langmia IM, Lee WL, Harun R, Ismail R, et al.

Xenobiotica, 2008 Jun;38(6):641-51.
PMID: 18570163 DOI: 10.1080/00498250801999087

1. A retrospective study was conducted to explore the importance of CYP2C9 genotyping for the initiation and maintenance therapy of warfarin in clinical practice. A total of 191 patients on warfarin therapy in a local hospital were recruited after written informed consent. Their medical records were reviewed and no intervention of warfarin dose was performed. 2. A total of 5 ml of blood were taken from each subject for DNA extraction and identification of 1, 2, 3 and 4 CYP2C9 alleles, using a nested-allele-specific-multiplex-polymerase chain reaction (PCR). Half the patients were Malays and the remaining were Chinese. 3. Two genotypes were detected; 93.2% had CYP2C9 1/1 and 6.8% were CYP2C9 1/3. Warfarin doses were higher in patients with CYP2C91/1. Patients with the 1/3 genotype experienced a higher rate of serious and life-threatening bleeding; 15.4 versus 6.2 per 100 patients per 6 months. 4. The observation clearly highlights the inadequacy of the current dosing regimens and the need to move toward a more individualized approach to warfarin therapy. Prospective clinical studies are now being conducted to assess dosing algorithms that incorporate the contribution of the genotype to allow the individualization of warfarin dose.
Test-retest reliability of HeartQoL and its comparability to the MacNew heart disease health-related quality of life questionnaire

Lee WL, Chinna K, Bulgiba A, Abdullah KL, Abidin IZ, Höfer S

Qual Life Res, 2016 Feb;25(2):351-357.
PMID: 26254801 DOI: 10.1007/s11136-015-1097-1

OBJECTIVES: Heart Quality of Life (HeartQoL) is a new "hybrid" developed from the MacNew and two condition-specific questionnaires measuring health-related quality of life (HRQoL) in patients with ischemic heart disease (IHD). This study investigates test-retest reliability of HeartQoL (English version) according to international criteria (e.g., COSMIN, GRRAS). Findings on HeartQoL are compared to the published data on MacNew in view that both serve as the core IHD-specific HRQoL instrument.
METHODS: Out of 105 patients with IHD, 76 completed self-administration of HeartQoL at the clinic followed by at home within a 2-week interval. In retest, patients responded using non-interview methods (phone messaging, email, fax, and post). Phone interviewing was reserved for non-respondents to reminder.
RESULTS: Reliability of HeartQoL was good (intraclass correlation coefficients = 0.78-0.82), was supported in the Bland-Altman plot, and was comparable to five studies on MacNew of similar retest interval (MacNew-English = 0.70-0.75; translated MacNew = 0.72-0.91). Applicability of its standard error of measurement (0.20-0.25) and smallest detectable change (0.55-0.70) will depend on availability of normative data in future.
CONCLUSION: The reliability of HeartQoL is comparable to its parent instrument, the MacNew. The HeartQoL is a potentially reliable core IHD-specific HRQoL instrument in measuring group change.
Mitigation of COVID-19 Risk Among Older Adults in Nursing Homes: A Public Survey

Lee WL, DeWitt D, Chui PL, Sahibudeen AKS, Nurumal MS, Chinna K, et al.

J Gerontol Nurs, 2021 Mar 01;47(3):23-28.
PMID: 33626161 DOI: 10.3928/00989134-20210209-04

The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23-28.].
Fulltext Detection of Prostate Cancer via IR Spectroscopic Analysis of Urinary Extracellular Vesicles: A Pilot Study

Yap XL, Wood B, Ong TA, Lim J, Goh BH, Lee WL

Membranes (Basel), 2021 Jul 31;11(8).
PMID: 34436354 DOI: 10.3390/membranes11080591

Extracellular vesicles (EVs) are membranous nanoparticles naturally released from living cells which can be found in all types of body fluids. Recent studies found that cancer cells secreted EVs containing the unique set of biomolecules, which give rise to a distinctive absorbance spectrum representing its cancer type. In this study, we aimed to detect the medium EVs (200-300 nm) from the urine of prostate cancer patients using Fourier transform infrared (FTIR) spectroscopy and determine their association with cancer progression. EVs extracted from 53 urine samples from patients suspected of prostate cancer were analyzed and their FTIR spectra were preprocessed for analysis. Characterization of morphology, particle size and marker proteins confirmed that EVs were successfully isolated from urine samples. Principal component analysis (PCA) of the EV's spectra showed the model could discriminate prostate cancer with a sensitivity of 59% and a specificity of 81%. The area under curve (AUC) of FTIR PCA model for prostate cancer detection in the cases with 4-20 ng/mL PSA was 0.7, while the AUC for PSA alone was 0.437, suggesting the analysis of urinary EVs described in this study may offer a novel strategy for the development of a noninvasive additional test for prostate cancer screening.
Fulltext Anti-dengue virus serotype 2 activity of tannins from porcupine dates

Pong LY, Yew PN, Lee WL, Lim YY, Sharifah SH

Chin Med, 2020;15:49.
PMID: 32467721 DOI: 10.1186/s13020-020-00329-7

Background: Dengue fever is currently endemic in tropical and subtropical countries worldwide and effective drug against DENV infection is still unavailable. Porcupine dates, which are traditionally used to treat dengue fever, might contain potential anti-dengue compounds. Two porcupine dates, black date (BD) and powdery date (PD) from Himalayan porcupine (Hystrix brachyura), were investigated for their antiviral activities against DENV-2 in vitro.
Methods: The methanol crude extracts (MBD and MPD) were prepared from the raw material of porcupine dates. The tannin-rich fractions (BDTF and PDTF) were isolated from their methanol crude extracts using column chromatography. The presence of tannins in BDTF and PDTF extracts was determined by fourier-transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR) analyses. The cytotoxicity and anti-DENV-2 activities including virus yield inhibition, virucidal, virus attachment and pre-treatment assays of the extracts were examined in Vero cells.
Results: Our findings revealed that all the extracts of porcupine dates exhibited antiviral activity against DENV-2 in Vero cells. The IC50 of BDTF and PDTF were 25 µg/mL and 11 µg/mL respectively, while their methanol crude extracts demonstrated lower antiviral efficacy (IC50 ≈ 101-107 µg/mL). BDTF and PDTF also exerted a similar higher virucidal effect (IC50 of 11 µg/mL) than methanol crude extracts (IC50 ≈ 52-66 µg/mL). Furthermore, all the extracts inhibited the attachment of DENV-2 by at least 80%. Pre-treatments of cells with BDTF and PDTF markedly prevented DENV-2 infection when compared to methanol crude extracts.
Conclusion: This study suggests that porcupine dates possess antiviral properties against DENV-2, which is attributed to its tannin compounds.
Impact of increased digital use and internet gaming on nursing students' empathy: A cross-sectional study

Lee WL, Rambiar PNIMS, Rosli NQB, Nurumal MS, Abdullah SSS, Danaee M

Nurse Educ Today, 2022 Dec;119:105563.
PMID: 36150294 DOI: 10.1016/j.nedt.2022.105563

BACKGROUND: The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait.
OBJECTIVE: Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide.
DESIGN: Cross-sectional online survey was conducted from October to December 2020.
SETTINGS: Two established public institutions located in Malaysia.
PARTICIPANTS: A total of 345 nursing students pursuing diploma and bachelor nursing programs.
METHODS: Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3).
RESULTS: Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (β = -0.111, -0.192; p values < 0.05) and higher callousness (β = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (β = 0.265, p
A simple multiplex PCR method for the concurrent detection of three CYP2C8 variants

Muthiah YD, Lee WL, Teh LK, Ong CE, Salleh MZ, Ismail R

Clin Chim Acta, 2004 Nov;349(1-2):191-8.
PMID: 15469873 DOI: 10.1016/j.cccn.2004.06.024

BACKGROUND: Cytochrome P450 (CYP) 2C8 is a principle enzyme responsible for the metabolism of many clinically important drugs as well as endogenous compounds such as arachidonic acid. The enzyme is genetically polymorphic but a simple method is not available to study its genetic polymorphism. We developed and optimized a variant-specific PCR techniques to detect CYP2C8*2, CYP2C8*3 and CYP2C8*4.
METHOD: Genomic DNA was extracted from blood using standard extraction methods. A two-step PCR method was developed to detect simultaneously three CYP2C8 variants. In the first PCR (PCR1), specific regions from exons 3, 5 and 8 of the CYP2C8 gene were amplified. The products were used as templates in parallel alleles-specific PCR (PCR2). This method was tested against DNA samples obtained from 57 healthy Malaysian volunteers.
RESULT: The bands of interest were successfully amplified. This method showed specific and reproducible results when tested on healthy volunteers. DNA sequencing further confirmed genotype results obtained from current method.
CONCLUSION: We have successfully developed and optimized a multiplex PCR method suitable for use in population studies of CYP2C8 polymorphism.

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