METHODS AND ANALYSIS: A three-step approach consensus approach will be adopted for this study for the development of a validated medical curriculum guideline on AMR. A preliminary curriculum for the programme will be drafted from reviews of published literature including syllabi as well as national and international guidelines. A total of 26 potential sources were found to be relevant, and selected for this study. Subsequently, the drafted curriculum will be subjected for validation via online surveys by various infectious disease experts. Finally, a Delphi technique will be employed to obtain consensus on heterogeneous findings to the revised curriculum. The quantitative and qualitative responses will be analysed and discussed among the panel of researchers.
ETHICS AND DISSEMINATION: This study protocol has been approved by the Institute of Health Sciences Research Ethics Committee of Universiti Brunei Darussalam (Reference: UBD/PAPRSBIHSREC/2020/124). Informed consent declaration will be collected prior to data collections as indication of agreement of participation in the study. Results will be made available to medical educators and also researchers on AMR and stewardship. The results also will be disseminated at feedback sessions to officers at Ministry of Health and Ministry of Education, Brunei Darussalam.
METHODS: The recombinant BipD protein was produced, followed by isolation of BipD-specific aptamers using Systematic Evolution of Ligands by EXponential enrichment. The binding affinity and specificity of the selected aptamers were evaluated using Enzyme-Linked Oligonucleotide Assay.
RESULTS: The fifth SELEX cycle showed a notable enrichment of recombinant BipD protein-specific aptamers. Sequencing analysis identified two clusters with a total of seventeen distinct aptamers. AptBipD1, AptBipD13, and AptBipD50 were chosen based on their frequency. Among them, AptBipD1 exhibited the highest binding affinity with a Kd value of 1.0 μM for the recombinant BipD protein. Furthermore, AptBipD1 showed significant specificity for B. pseudomallei compared to other tested bacteria.
CONCLUSION: AptBipD1 is a promising candidate for further development of reliable, affordable, and efficient point-of-care diagnostic tests for melioidosis.
METHODS: Sixty-four extracted mandibular molars were root-treated and lined with flowable composite (1.5 mm thickness) before being embedded in epoxy resin blocks. The samples were divided into four groups (n = 16): three endocrown groups with different preparation designs (butt-joint, 0.8 mm chamfer, and 1.0 mm shoulder) and one group with conventional crowns. Crown preparations were performed with a high-speed handpiece mounted on a modified milling device, targeting a 2.0 mm anatomical occlusal reduction for conventional crowns and a 4.0 mm central chamber depth with a 2.0 mm axial wall height (ferrule) for endocrowns (except the butt-joint design, which had no ferrule preparation). Restorations were fabricated using the Chairside Economical Restoration of Esthetic Ceramics (CEREC) Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) system with lithium disilicate (IPS e.max CAD; minimum occlusal thickness: 1.5 mm) as the restorative material and cemented with the RelyX Ultimate dual-cure resin adhesive. After 1,500 thermocycling cycles, the samples were divided into two subgroups (n = 8) for axial and oblique loading tests. The fracture resistance was tested using a universal testing machine at a crosshead speed of 0.5 mm/min, applying a load of up to 5,000 N until fracture. Failure modes were examined using a stereomicroscope at 5x magnification and categorized as catastrophic or non-catastrophic. The mean fracture resistance was compared using one-way Analysis of Variance (ANOVA) with Bonferroni post-hoc tests, and Fisher's exact test was used to assess the association between preparation designs and failure modes (p < 0.05).
RESULTS: Endocrowns with shoulder margins showed significantly higher fracture resistance (3,042.83 ± 850.76 N) than conventional crowns (1,908.28 ± 635.82 N) under axial loading (p = 0.02). No significant differences were found under oblique loading between the preparation designs. The preparation design significantly influenced the failure mode under axial loading (p = 0.049). Endocrowns exhibited a higher rate of catastrophic fractures than conventional crowns, regardless of loading direction.
CONCLUSIONS: Endocrowns provide a conservative alternative to conventional crowns, offering a higher fracture resistance under axial loading. Further research is needed to evaluate the endocrown performance under oblique loading.
METHODS: Human Müller cells were cultured in low and high glucose conditions. Cells were treated with xamoterol (selective agonist for β1-AR), salmeterol (selective agonist for β2-AR), isoproterenol (β-ARs agonist) and propranolol (β-ARs antagonist), at 20 µM concentration for 24 h. Western Blotting assay was performed for the gene expression analysis. DNA damage was evaluated by TUNEL assay. DCFH-DA assay was used to check the level of reactive oxygen species (ROS). Cytochrome C release was measured by ELISA.
RESULTS: Xamoterol, salmeterol and isoproterenol showed no effect on Caspase-8 but it reduced the apoptosis and increased the expression of BDNF in Müller cells. A significant change in the expression of caspase-3 was observed in cells treated with xamoterol and salmeterol as compared to isoproterenol. Xamoterol, salmeterol and isoproterenol significantly decreased the reactive oxygen species (ROS) when treated for 24 hours. Glucose-induced cytochrome c release was disrupted in Müller cells.
CONCLUSION: β-ARs, stimulated by agonist play a protective role in hyperglycemic Müller cells, with the suppression of glucose-induced caspase-3 and cytochrome c release. B-Ars may directly mediate the gene expression of BDNF.
Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.
Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.
Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.