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  1. Sirkkunan DS, Muhamad F, Pingguan-Murphy B
    Gels, 2021 Sep 27;7(4).
    PMID: 34698174 DOI: 10.3390/gels7040154
    The use of neural scaffolds with a highly defined microarchitecture, fabricated with standard techniques such as electrospinning and microfluidic spinning, requires surgery for their application to the site of injury. To circumvent the risk associated with aciurgy, new strategies for treatment are sought. This has led to an increase in the quantity of research into injectable hydrogels in recent years. However, little research has been conducted into controlling the building blocks within these injectable hydrogels to produce similar scaffolds with a highly defined microarchitecture. "Magnetic particle string" and biomimetic amphiphile self-assembly are some of the methods currently available to achieve this purpose. Here, we developed a "magnetic anchor" method to improve the orientation of collagen fibres within injectable 3D scaffolds. This procedure uses GMNP (gold magnetic nanoparticle) "anchors" capped with CMPs (collagen mimetic peptides) that "chain" them to collagen fibres. Through the application of a magnetic field during the gelling process, these collagen fibres are aligned accordingly. It was shown in this study that the application of CMP functionalised GMNPs in a magnetic field significantly improves the alignment of the collagen fibres, which, in turn, improves the orientation of PC12 neurites. The growth of these neurite extensions, which were shown to be significantly longer, was also improved. The PC12 cells grown in collagen scaffolds fabricated using the "magnetic anchor" method shows comparable cellular viability to that of the untreated collagen scaffolds. This capability of remote control of the alignment of fibres within injectable collagen scaffolds opens up new strategic avenues in the research for treating debilitating neural tissue pathologies.
  2. Teo K, Yong CW, Muhamad F, Mohafez H, Hasikin K, Xia K, et al.
    J Healthc Eng, 2021;2021:9208138.
    PMID: 34765104 DOI: 10.1155/2021/9208138
    Quality of care data has gained transparency captured through various measurements and reporting. Readmission measure is especially related to unfavorable patient outcomes that directly bends the curve of healthcare cost. Under the Hospital Readmission Reduction Program, payments to hospitals were reduced for those with excessive 30-day rehospitalization rates. These penalties have intensified efforts from hospital stakeholders to implement strategies to reduce readmission rates. One of the key strategies is the deployment of predictive analytics stratified by patient population. The recent research in readmission model is focused on making its prediction more accurate. As cost-saving improvements through artificial intelligent-based health solutions are expected, the broad economic impact of such digital tool remains unknown. Meanwhile, reducing readmission rate is associated with increased operating expenses due to targeted interventions. The increase in operating margin can surpass native readmission cost. In this paper, we propose a quantized evaluation metric to provide a methodological mean in assessing whether a predictive model represents cost-effective way of delivering healthcare. Herein, we evaluate the impact machine learning has had on transitional care and readmission with proposed metric. The final model was estimated to produce net healthcare savings at over $1 million given a 50% rate of successfully preventing a readmission.
  3. Saadon I, Amit B, Zolquarnian A, Muhamad F
    Malays Orthop J, 2017 Jul;11(2):64-67.
    PMID: 29021882 MyJurnal DOI: 10.5704/MOJ.1707.010
    Musculoskeletal tumours of the lower limbs especially malignant tumours are not common. The fibula is the site of primary bone tumours as reported in 2.4% of lower limb tumours with the proximal third being more frequently involved than the distal segment. Osteosarcoma is the most common primary malignant bone tumour of nonhaematopoietic origin, with distal fibular involvement in 0.47% of patients. The advances in imaging techniques and neo-adjuvant chemotherapy have now made it possible to accurately define the extent of tumour and plan limb salvage with tumour resection. The purpose of this case report is to highlight the successful outcome of limb salvage procedure with a five year follow up in an 11-year old boy with distal fibular osteosarcoma. Limb salvage surgery with distal fibulectomy and retention of the foot are a good alternative to radical amputation.
  4. Naureen B, Haseeb ASMA, Basirun WJ, Muhamad F
    Mater Sci Eng C Mater Biol Appl, 2021 Jan;118:111228.
    PMID: 33254956 DOI: 10.1016/j.msec.2020.111228
    Organ repair, regeneration, and transplantation are constantly in demand due to various acute, chronic, congenital, and infectious diseases. Apart from traditional remedies, tissue engineering (TE) is among the most effective methods for the repair of damaged tissues via merging the cells, growth factors, and scaffolds. With regards to TE scaffold fabrication technology, polyurethane (PU), a high-performance medical grade synthetic polymer and bioactive material has gained significant attention. PU possesses exclusive biocompatibility, biodegradability, and modifiable chemical, mechanical and thermal properties, owing to its unique structure-properties relationship. During the past few decades, PU TE scaffold bioactive properties have been incorporated or enhanced with biodegradable, electroactive, surface-functionalised, ayurvedic products, ceramics, glass, growth factors, metals, and natural polymers, resulting in the formation of modified polyurethanes (MPUs). This review focuses on the recent advances of PU/MPU scaffolds, especially on the biomedical applications in soft and hard tissue engineering and regenerative medicine. The scientific issues with regards to the PU/MPU scaffolds, such as biodegradation, electroactivity, surface functionalisation, and incorporation of active moieties are also highlighted along with some suggestions for future work.
  5. Murugiah UR, Ramoo V, Jamaluddin MFH, Yahya A, Baharudin AA, Abu H, et al.
    Nurs Crit Care, 2021 09;26(5):363-371.
    PMID: 33569880 DOI: 10.1111/nicc.12600
    BACKGROUND: Nurses play a key role in the proper management of endotracheal tube (ETT) cuff pressure, which is important for patients' safety, so it is vital to improve nurses' knowledge on safe cuff management practices.

    AIMS AND OBJECTIVES: This study aimed to evaluate the effectiveness of an educational intervention related to ETT cuff pressure management on improving and retaining critical care nurses' knowledge.

    DESIGN: A single group pre-post interventional study was conducted involving 112 registered nurses (RNs) from a 24-bed adult general intensive care unit at a teaching hospital in Malaysia.

    METHODS: The educational intervention included a theoretical session on endotracheal cuff pressure management and demonstration plus hands-on practice with the conventional cuff pressure monitoring method. Nurses' knowledge was measured using a self-administered questionnaire pre- and post-intervention. Data were analysed using repeated measure analysis of variance and bivariate analysis.

    RESULTS: In this study, 92% of the total number of RNs in the unit participated. A significant difference in mean knowledge score was noted between the pre- (mean = 8.13; SD = 1.53) and post-intervention phases (3 months [mean = 8.97; SD = 1.57) and 9 months post-intervention [mean = 10.34; SD = 1.08), P 

  6. Susilawati S, Prayogi S, Arif MF, Ismail NM, Bilad MR, Asy'ari M
    Polymers (Basel), 2021 Mar 28;13(7).
    PMID: 33800592 DOI: 10.3390/polym13071065
    This study assesses the optical properties and conductivity of PVA-H3PO4 (polyvinyl alcohol-phosphoric acid) polymer film blend irradiated by gamma (γ) rays. The PVA-H3PO4 polymer film blend was prepared by the solvent-casting method at H3PO4 concentrations of 75 v% and 85 v%, and then irradiated up to 25 kGy using γ-rays from the Cobalt-60 isotope source. The optical absorption spectrum was measured using an ultraviolet-visible spectrophotometer over a wavelength range of 200 to 700 nm. It was found that the absorption peaks are in three regions, namely two peaks in the ultraviolet region (310 and 350 nm) and one peak in the visible region (550 nm). The presence of an absorption peak after being exposed to hυ energy indicates a transition of electrons from HOMO to LUMO within the polymer chain. The study of optical absorption shows that the energy band gap (energy gap) depends on the radiation dose and the concentration of H3PO4 in the polymer film blend. The optical absorption, absorption edge, and energy gap decrease with increasing H3PO4 concentration and radiation dose. The interaction between PVA and H3PO4 blend led to an increase in the conductivity of the resulting polymer blend film.
  7. Abdullah MF, Nuge T, Andriyana A, Ang BC, Muhamad F
    Polymers (Basel), 2019 Dec 04;11(12).
    PMID: 31817133 DOI: 10.3390/polym11122008
    The key attributes of core-shell fibers are their ability to preserve bioactivity of incorporated-sensitive biomolecules (such as drug, protein, and growth factor) and subsequently control biomolecule release to the targeted microenvironments to achieve therapeutic effects. Such qualities are highly favorable for tissue engineering and drug delivery, and these features are not able to be offered by monolithic fibers. In this review, we begin with an overview on design requirement of core-shell fibers, followed by the summary of recent preparation methods of core-shell fibers, with focus on electrospinning-based techniques and other newly discovered fabrication approaches. We then highlight the importance and roles of core-shell fibers in tissue engineering and drug delivery, accompanied by thorough discussion on controllable release strategies of the incorporated bioactive molecules from the fibers. Ultimately, we touch on core-shell fibers-related challenges and offer perspectives on their future direction towards clinical applications.
  8. Yew CHT, Azari P, Choi JR, Muhamad F, Pingguan-Murphy B
    Polymers (Basel), 2018 Dec 14;10(12).
    PMID: 30961312 DOI: 10.3390/polym10121387
    Electrospun polycaprolactone (PCL) nanofibers have emerged as a promising material in diverse biomedical applications due to their various favorable features. However, their application in the field of biosensors such as point-of-care lateral flow assays (LFA) has not been investigated. The present study demonstrates the use of electrospun PCL nanofibers as a reaction membrane for LFA. Electrospun PCL nanofibers were treated with NaOH solution for different concentrations and durations to achieve a desirable flow rate and optimum detection sensitivity in nucleic acid-based LFA. It was observed that the concentration of NaOH does not affect the physical properties of nanofibers, including average fiber diameter, average pore size and porosity. However, interestingly, a significant reduction of the water contact angle was observed due to the generation of hydroxyl and carboxyl groups on the nanofibers, which increased their hydrophilicity. The optimally treated nanofibers were able to detect synthetic Zika viral DNA (as a model analyte) sensitively with a detection limit of 0.5 nM. Collectively, the benefits such as low-cost of fabrication, ease of modification, porous nanofibrous structures and tunability of flow rate make PCL nanofibers a versatile alternative to nitrocellulose membrane in LFA applications. This material offers tremendous potential for a broad range of point-of-care applications.
  9. Al-Haddad AY, Kacharaju KR, Haw LY, Yee TC, Rajantheran K, Mun CS, et al.
    J Contemp Dent Pract, 2020 Nov 01;21(11):1218-1221.
    PMID: 33850066
    AIM: This study aimed to evaluate the effect of the prior application of intracanal medicaments on the bond strength of OrthoMTA (mineral trioxide aggregate) and iRoot SP to the root dentin.

    MATERIALS AND METHODS: Thirty single-rooted mandibular premolars were standardized and prepared using ProTaper rotary files. The specimens were divided into a control group and two experimental groups receiving Diapex and Odontopaste medicament, either filled with iRoot SP or OrthoMTA, for 1 week. Each root was sectioned transversally, and the push-out bond strength and failure modes were evaluated. The data were analyzed using Kruskal Wallis and Mann-Whitney U post hoc test.

    RESULTS: There was no significant difference between the bond strength of iRoot SP and OrthoMTA without medicaments and with the prior placement of Diapex (p value > 0.05). However, iRoot SP showed significantly higher bond strength with the prior placement of Odontopaste (p value < 0.05). Also, there was no association between bond strength of OrthoMTA with or without intracanal medicament (p value > 0.05) and between failure mode and root filling materials (p value > 0.05). The prominent failure mode for all groups was cohesive.

    CONCLUSION: Prior application of Diapex has no effect on the bond strength of iRoot SP and OrthoMTA. However, Odontopaste improved the bond strength of iRoot SP.

    CLINICAL SIGNIFICANCE: Dislodgment resistance of root canal filling from root dentin could be an indicator of the durability and prognosis of endodontic treated teeth.

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