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  1. Lazim MRMLM, Chellappan K, Ugusman A, Isa WYHW, Mohamad MSF, Ahmad WANW, et al.
    Int J Med Sci, 2025;22(2):309-317.
    PMID: 39781517 DOI: 10.7150/ijms.103341
    Background: The finger photoplethysmography fitness index (PPGF), a marker of peripheral vascular function, has been linked to heart rate (HR) variability. However, the influence of acute HR changes on resting PPGF, a purported indicator of local blood flow, remains unclear. Objective: This study aimed to determine the influence of acute HR changes on resting PPGF. Methods: A total of 22 pacemaker recipients (mean age: 52.27 ± 10.43 years) underwent a controlled study. Baseline assessments included demographics, blood pressure (BP), blood analysis, PPGF, and vascular functions. HR was progressively increased from 70 bpm to 90 bpm in 10 bpm increments with 20 min resting periods at baseline and between pacing intervals. HR, PPGF, and BP were recorded at each pacing level. Results: Systolic and diastolic BP increased with rising HR. Conversely, PPGF remained stable across different HR levels (70 bpm: 51.02 ± 11.52%, 80 bpm: 51.15 ± 11.82%, 90 bpm: 49.73 ± 11.55%; p > 0.05), suggesting that resting PPGF is independent of acute HR fluctuations. Conclusion: Our findings demonstrate that PPGF accurately reflects local blood flow, unaffected by short-term HR variations. This study supports the use of PPGF as a reliable marker for vascular health and age assessment, even in individuals with fluctuating HR, such as older adults with multiple comorbidities. Further research is warranted to establish the applicability of PPGF in younger, healthier populations.
    Matched MeSH terms: Female
  2. Lui JNM, Lau ESH, Li AQY, Zhang Y, Lim LL, Chun-KwunO, et al.
    Diabetes Res Clin Pract, 2025 Jan;219:111961.
    PMID: 39701541 DOI: 10.1016/j.diabres.2024.111961
    OBJECTIVE: We examined incremental healthcare costs (inpatient and outpatient) related to complications in Chinese patients with type 2 diabetes (T2D) during the year of occurrence and post-event years, utilizing the Joint Asia Diabetes Evaluation (JADE) Register cohort of Hong Kong Chinese patients with T2D between 2007 and 2019.

    RESEARCH DESIGN AND METHODS: 19,440 patients with T2D underwent structured evaluation utilizing the JADE platform with clinical outcomes data retrieved from territory-wide electronic medical records including inpatient, outpatient and emergency care. Two-part model was adopted to account for skewed healthcare costs distribution. Incremental healthcare costs associated with nine non-fatal diabetes complications and all-cause death were estimated, adjusted for demographic, clinical, lifestyle factors and comorbidities.

    RESULTS: In this prospective cohort [mean ± SD age:59.9 ± 11.9 years, 56.6 % men, duration of diabetes:7.3 ± 7.5 years, HbA1C:7.5 ± 1.6 %] observed for 7 (interquartile range:4-9) years (142,132 patient-years), the mean annual healthcare costs, mainly due to inpatient cost, were USD$2,990 ± 9,960. Lower extremity amputation (LEA) (USD$31,302; 95 %CI: 25,706-37,004), hemorrhagic stroke (USD$21,164; 17,680-24,626), ischemic stroke (USD$17,976; $15,937-20,352) and end-stage disease (ESRD) (USD$14,774; 13,405-16,250) in the year of event incurred the highest cost. Residual healthcare costs in the post-event years were highest for ESRD, LEA, haemorrhagic stroke and incident cancer.

    CONCLUSION: These comprehensive temporal healthcare cost estimates for diabetes-related complications allows the performance of long-term, patient-level, cost-effectiveness analyses on T2D prevention and treatment strategies relevant to an Asian and possibly global contexts. These may inform decision-makers on resource allocation aimed at reducing the burden of T2D and chronic diseases.

    Matched MeSH terms: Female
  3. Parlatini V, Bellato A, Roy S, Murphy D, Cortese S
    J Child Adolesc Psychopharmacol, 2024 Oct;34(8):337-345.
    PMID: 39027968 DOI: 10.1089/cap.2024.0038
    Objectives: Stimulants, such as methylphenidate (MPH) and amphetamines, represent the first-line pharmacological option for attention-deficit/hyperactivity disorder (ADHD). Randomized controlled trials (RCTs) have demonstrated beneficial effects at a group level but could not identify characteristics consistently associated with varying individual response. Thus, more individualized approaches are needed. Experimental studies have suggested that the neurobiological response to a single dose is indicative of longer term response. It is unclear whether this also applies to clinical measures. Methods: We carried out a systematic review of RCTs testing the association between the clinical response to a single dose of stimulants and longer term improvement. Potentially suitable single-dose RCTs were identified from the MED-ADHD data set, the European ADHD Guidelines Group RCT Data set (https://med-adhd.org/), as updated on February 1, 2024. Quality assessment was carried out using the Cochrane Risk of Bias (RoB) 2.0 tool. Results: A total of 63 single-dose RCTs (94% testing MPH, 85% in children) were identified. Among these, only a secondary analysis of an RCT tested the association between acute and longer term clinical response. This showed that the clinical improvement after a single dose of MPH was significantly associated with symptom improvement after a 4-week MPH treatment in 46 children (89% males) with ADHD. The risk of bias was rated as moderate. A further RCT used near-infrared spectroscopy, thus did not meet the inclusion criteria, and reported an association between brain changes under a single-dose and longer term clinical response in 22 children (82% males) with ADHD. The remaining RCTs only reported single-dose effects on neuropsychological, neuroimaging, or neurophysiological measures. Conclusion: This systematic review highlighted an important gap in the current knowledge. Investigating how acute and long-term response may be related can foster our understanding of stimulant mechanism of action and help develop stratification approaches for more tailored treatment strategies. Future studies need to investigate potential age- and sex-related differences.
    Matched MeSH terms: Female
  4. Fashafsheh N, Chui PL, Danaee M, Ayed A, Lai LL
    Hemodial Int, 2025 Jan;29(1):83-92.
    PMID: 39396928 DOI: 10.1111/hdi.13182
    INTRODUCTION: Hemodialysis is frequently used as a primary treatment for individuals with end-stage kidney disease (ESKD), and it significantly impacts the quality of life in adolescents undergoing this procedure. Providing a hemodialysis education to these patients is a valuable strategy for enhancing their well-being. The aim of the study is to assess the effect of the video-assisted educational program on the quality of life among adolescents undergoing hemodialysis in Palestine.

    METHODS: This study employed a quasi-experimental design, a pre-test-post-test interventional study, involving a sample of 68 adolescent patients between the ages of 13 and 18 diagnosed with ESKD. The quality of life level was assessed in both groups using an Arabic version of the Pediatric Quality of Life Inventory™ version 3.0 ESKD Module survey. The study was conducted at the dialysis units in four hospitals associated with Augusta Victoria Hospital, An-Najah University Hospital, Palestine Medical Complex/Ramallah, and Beit Jala (Al Housain) Hospital. The study involved providing tailored face-to-face educational sessions with video assistance to the experimental group, while the control group received regular face-to-face education.

    FINDINGS: The Generalized Estimating Equation analysis revealed no significant differences in quality of life between the experimental and control groups over time, across pre-test, post-test, and follow-up periods (p ≥ 0.05). However, within the experimental group, there was a significant improvement in total quality of life scores between the pre-test, post-test, and post-test follow-up (p ≤ 0.001), although the difference between the pre-test and follow-up approached significance but was not statistically significant (p = 0.056). In contrast, the control group showed significant differences in quality of life across the pre-test, post-test, and follow-up time points (p ≤ 0.05).

    DISCUSSION: Implementing suitable interventions can potentially enhance the quality of life for individuals undergoing hemodialysis. Consequently, we suggest using video-based education as a cost-effective, uncomplicated, and engaging approach for educating hemodialysis patients.

    Matched MeSH terms: Female
  5. Patriquin CJ, Bogdanovic A, Griffin M, Kelly RJ, Maciejewski JP, Mulherin B, et al.
    Adv Ther, 2024 May;41(5):2050-2069.
    PMID: 38573482 DOI: 10.1007/s12325-024-02827-8
    INTRODUCTION: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening disease characterized by complement-mediated hemolysis and thrombosis. Pegcetacoplan, the first targeted complement component 3 (C3) PNH therapy, was safe and efficacious in treatment-naive and pre-treated patients with PNH in five clinical trials.

    METHODS: The 307 open-label extension (OLE) study (NCT03531255) is a non-randomized, multicenter extension study of long-term safety and efficacy of pegcetacoplan in adult patients with PNH who completed a pegcetacoplan parent study. All patients received pegcetacoplan. Outcomes at the 48-week data cutoff (week 48 of 307-OLE or August 27, 2021, whichever was earlier) are reported. Hemoglobin concentrations, Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scores, and transfusion avoidance were measured. Hemoglobin > 12 g/dL and sex-specific hemoglobin normalization (i.e., male, ≥ 13.6 g/dL; female, ≥ 12 g/dL) were assessed as percentage of patients with data available and no transfusions 60 days before data cutoff. Treatment-emergent adverse events, including hemolysis, were reported.

    RESULTS: Data from 137 patients with at least one pegcetacoplan dose at data cutoff were analyzed. Mean (standard deviation [SD]) hemoglobin increased from 8.9 (1.22) g/dL at parent study baseline to 11.6 (2.17) g/dL at 307-OLE entry and 11.6 (1.94) g/dL at data cutoff. At parent study baseline, mean (SD) FACIT-Fatigue score of 34.1 (11.08) was below the general population norm of 43.6; scores improved to 42.8 (8.79) at 307-OLE entry and 42.4 (9.84) at data cutoff. In evaluable patients, hemoglobin > 12 g/dL occurred in 40.2% (43 of 107) and sex-specific hemoglobin normalization occurred in 31.8% (34 of 107) at data cutoff. Transfusion was not required for 114 of 137 patients (83.2%). Hemolysis was reported in 23 patients (16.8%). No thrombotic events or meningococcal infections occurred.

    CONCLUSION: Pegcetacoplan sustained long-term improvements in hemoglobin concentrations, fatigue reduction, and transfusion burden. Long-term safety findings corroborate the favorable profile established for pegcetacoplan.

    TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03531255.

    Matched MeSH terms: Female
  6. Wang L, Zou W, Wang Y, Koh D, Munsif Bin Wan Pa WA, Gao R
    Sci Rep, 2025 Jan 09;15(1):1461.
    PMID: 39789314 DOI: 10.1038/s41598-025-85725-5
    To improve the scientific accuracy and precision of children's physical fitness evaluations, this study proposes a model that combines self-organizing maps (SOM) neural networks with cluster analysis. Existing evaluation methods often rely on traditional, single statistical analyses, which struggle to handle the complexity of high-dimensional, nonlinear data, resulting in a lack of precision and personalization. This study uses the SOM neural network to reduce the dimensionality of high-dimensional health data. Moreover, it integrates cluster analysis to categorize and analyze key physical fitness attributes, such as strength, flexibility, and endurance. Experimental results show that the proposed optimized model outperforms comparison models such as T-distributed stochastic neighbor embedding, density peak clustering, and deep embedded clustering in terms of performance. The accuracy for the strength dimension reaches 0.934, the F1 score is 0.862, and the area under the curve of receiver operating characteristic is 0.944. The silhouette coefficients for cluster analysis in strength, flexibility, and endurance dimensions are 0.655, 0.559, and 0.601, respectively, demonstrating good intra-class and inter-class distances. The proposed model enhances the comprehensive analysis of children's physical fitness and provides a scientific basis for personalized health interventions, making an important contribution to research in this field.
    Matched MeSH terms: Female
  7. Gordon Smith CE, Turner LH, Harrison JL, Broom JC
    Bull World Health Organ, 1961;24(6):807-16.
    PMID: 20604093
    In previous papers it has been demonstrated that ground-dwelling rats are the principal reservoir of leptospirosis in Malaya. The present paper considers the distribution of infection by sex and weight in the ten principal rat species. There appears to be a general tendency for females to be infected more frequently than males, but significant differences were demonstrated only in R. sabanus (more than three times as many females as males infected) and R. whiteheadi. In Malaya, where seasonal changes are minimal, weights can be used as a good index of age in rats. In rat species with a low incidence of infection the incidence appeared to rise steadily with age. In species with a medium incidence the infection rate rose at first with age, fell in the 6-8-month age-group, and then rose again. In high-incidence species the rate rose rapidly from the second month.There appear to be three types of enzootic infection; (1) intensive transmission of a single serogroup in a crowded population of rats of a single species (transmission probably being through urinary contamination of damp soil); (2) low-intensity transmission of several serogroups among ground-rats frequenting wet places (probably with urinary transmission); and (3) low-intensity transmission of several serogroups among ground-rats in dry places (the transmission may be venereal).
    Matched MeSH terms: Female
  8. Darbandi A, Koupaei M, Kiani P, Ghanavati R, Najafi P, Hosseini J, et al.
    Immun Inflamm Dis, 2024 Nov;12(11):e70076.
    PMID: 39570098 DOI: 10.1002/iid3.70076
    BACKGROUND: Despite the advent of vaccines against COVID-19, there is considerable variation in the acceptance and hesitancy towards the vaccination program across different countries. The objective of this study was to ascertain the prevalence of hesitancy and acceptance regarding the use of the vaccine against the novel coronavirus, also known as COVID-19, and to identify the factors that influence these attitudes.

    MATERIALS AND METHODS: All the cross-sectional studies were retrieved from the PubMed databases, the Web of Science ISI, Scopus, and the Cochrane Library. Papers published in English between 2 November 2019 and 23 May 2023 were subjected to further assessment based on their title, abstract, and main text, with a view to ensuring their relevance to the present study.

    RESULTS: Following an exhaustive investigation, 59 studies were selected for screening in this systematic review. The most frequently employed method of data collection was the online survey. The study sample comprised 59.12% women and 40.88% men, with ages ranging from 16 to 78 years. The proportion of individuals accepting the vaccine ranged from 13% to 96%, while the proportion of those exhibiting hesitancy ranged from 0% to 57.5%. The primary reasons for accepting the COIVD-19 vaccine were a heightened perception of risk associated with the virus and a general trust in the healthcare system. The most frequently cited reasons for vaccine hesitancy in the context of the ongoing pandemic include concerns about the potential dangers of the vaccines, the rapid pace of their development, the possibility of adverse effects (such as infertility or death), and the assumption that they have been designed to inject microchips.

    DISCUSSION: A variety of socio-demographic factors are implicated in determining the rate of vaccine acceptance. A number of socio-demographic factors have been identified as influencing vaccine acceptance. These include high income, male gender, older age, marriage, the presence of older children who have been vaccinated and do not have chronic diseases, high education, and health insurance coverage.

    CONCLUSION: Eliminating vaccine hesitancy or increasing vaccine acceptance is a crucial factor that should be addressed through various means and in collaboration with regulatory and healthcare organizations.

    Matched MeSH terms: Female
  9. Chia YC, Ching SM, Chew MT, Devaraj NK, Oui JEK, Lim HM, et al.
    Hypertens Res, 2025 Jan;48(1):131-147.
    PMID: 39223391 DOI: 10.1038/s41440-024-01851-z
    The association between high salt intake and elevated blood pressure levels has been well-documented. However, studies on how effectively this knowledge translates into actionable practices, particularly across different ethnic groups, remain limited. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) towards dietary salt intake across ethnicities and determine its association with hypertension. 5128 Malaysian adults recruited from a national blood pressure screening study completed questionnaires on demographics, and KAP related to dietary salt intake. There were 57.4% Malay, 23.5% Chinese, 10.4% Indian, and 8.7% individuals of other ethnic groups. Overall, more than 90% of the participants knew that a high salt intake causes serious health problems, but only around one-third knew the relationship between high salt intake and strokes and heart failure. Participants of different ethnic groups displayed significant differences in the KAP domains, where Indians generally exhibited better knowledge, attitudes, and reported better practices such as reading salt labels and using spices. Those who were unaware of the difference between salt and sodium and who reported not reading salt labels had higher odds of having elevated blood pressure. These findings demonstrate that while there is a suboptimal translation of salt knowledge into practice in Malaysia, with significant differences in KAP observed between ethnic groups, the potential of improving health outcomes by improving the clarity and awareness of salt labels is substantial. Tailored education promoting salt-label reading, minimizing processed foods intake and discretionary salt use should be ethnic-specific to better curb this escalating hypertension epidemic.
    Matched MeSH terms: Female
  10. Vékony B, Nyirő G, Herold Z, Fekete J, Ceccato F, Gruber S, et al.
    Hypertension, 2024 Dec;81(12):2479-2488.
    PMID: 39417220 DOI: 10.1161/HYPERTENSIONAHA.124.23418
    BACKGROUND: Distinguishing between unilateral and bilateral primary aldosteronism, a major cause of secondary hypertension, is crucial due to different treatment approaches. While adrenal venous sampling is the gold standard, its invasiveness, limited availability, and often difficult interpretation pose challenges. This study explores the utility of circulating microRNAs (miRNAs) and machine learning in distinguishing between unilateral and bilateral forms of primary aldosteronism.

    METHODS: MiRNA profiling was conducted on plasma samples from 18 patients with primary aldosteronism taken during adrenal venous sampling on an Illumina MiSeq platform. Bioinformatics and machine learning identified 9 miRNAs for validation by reverse transcription real-time quantitative polymerase chain reaction. Validation was performed on a cohort consisting of 108 patients with known subdifferentiation. A 30-patient subset of the validation cohort involved both adrenal venous sampling and peripheral, the rest only peripheral samples. A neural network model was used for feature selection and comparison between adrenal venous sampling and peripheral samples, while a deep-learning model was used for classification.

    RESULTS: Our model identified 10 miRNA combinations achieving >85% accuracy in distinguishing unilateral primary aldosteronism and bilateral adrenal hyperplasia on a 30-sample subset, while also confirming the suitability of peripheral samples for analysis. The best model, involving 6 miRNAs, achieved an area under curve of 87.1%. Deep learning resulted in 100% accuracy on the subset and 90.9% sensitivity and 81.8% specificity on all 108 samples, with an area under curve of 86.7%.

    CONCLUSIONS: Machine learning analysis of circulating miRNAs offers a minimally invasive alternative for primary aldosteronism lateralization. Early identification of bilateral adrenal hyperplasia could expedite treatment initiation without the need for further localization, benefiting both patients and health care providers.

    Matched MeSH terms: Female
  11. Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro-Costa E, et al.
    Alzheimers Dement, 2024 Jun;20(6):3972-3986.
    PMID: 38676366 DOI: 10.1002/alz.13846
    INTRODUCTION: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics.

    METHODS: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis.

    RESULTS: A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed.

    DISCUSSION: Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups.

    HIGHLIGHTS: A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.

    Matched MeSH terms: Female
  12. Siti Nurul Azimah MJ, Laily Noor Zuliaty A, Sharifah Shafinaz SA, Huzairi S
    Med J Malaysia, 2025 Jan;80(1):96-101.
    PMID: 39812435
    INTRODUCTION: The coronavirus disease of 2019 (COVID-19) predominantly impacts the pulmonary system; however, it also has harmful consequences for the cardiovascular system through the occurrence of myocardial injury.

    MATERIALS AND METHODS: This retrospective study analysed 119 COVID-19 patients admitted to Al-Sultan Abdullah Hospital (HASA) from March until December 2020. Demographics, medical histories, admission laboratory results, electrocardiogram (ECG), echocardiogram (echo), were captured from the hospitals' health records. Myocardial injury is an injury to the myocardium that can be diagnosed by elevated cardiac troponin T or I level above the 99th percentile upper reference limit (URL), an abnormal ECG, and an abnormal echo. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 27.

    RESULTS: From this study, it was founded that the prevalence of myocardial injury is 36.1% (43 subjects out of 119). The risk factors are older age (odds ratio, 2.347; p=0.028), males (odds ratio, 2.019; p=0.125), Indians (odds ratio, 3.659; p=0.296), hypertension (odds ratio, 2.776; p=0.009), diabetes mellitus (odds ratio, 1.732; p=0.155) and category 4 and 5 COVID-19 patients (odds ratio, 2.325; p=0.038).

    CONCLUSION: Myocardial injury is prevalent among patients affected by COVID-19 and is associated with older age, hypertension and category 4 and 5 COVID-19. The researchers suggested conducting a more thorough investigation of the sizable population in multiple settings and conducting a prospective study where all infected COVID-19 patients have to undergo several tests, such as ECG, troponin T, and echocardiogram.

    Matched MeSH terms: Female
  13. Tian M, Mohamad N, Gao XZ, Mohd Taib NH
    Med J Malaysia, 2025 Jan;80(1):88-95.
    PMID: 39812434
    INTRODUCTION: Contrast-enhanced ultrasound (CEUS), an in vivo imaging tool for evaluating intraplaque neovascularisation (IPN), is an increasingly researched marker of susceptible atherosclerotic plaque. This study aims to assess the feasibility of quantifying carotid IPN using CEUS and to identify and characterise the neovascularisation in carotid plaques. The hospital's ethical committee approved the study, and the informed individual consent form of CEUS was obtained from all patients before the examination.

    MATERIALS AND METHODS: Seventy-one patients with carotid atherosclerotic plaques (95 plaques) were studied on CEUS. Contrast enhancement in the plaque was evaluated with visual interpretation and quantitative analysis. The intraplaque neovascularisation (IPN) test was graded on a 3- point scale. IPN was quantified using dedicated software for CEUS image analysis.

    RESULTS: It was found that the CEUS quantitative parameters were significantly different for plaques with varying types of echoes. The quantitative parameters also differed in soft, hard, and mixed plaques. The quantification of carotid IPN using CEUS was found feasible. The quantitative parameters measured from CEUS provide multiple references for carotid IPN of different echo types. This can help identify and monitor unstable atherosclerotic plaques.

    CONCLUSION: CEUS has the potential to be an important tool in clinical application, specifically for diagnosing carotid atherosclerotic plaque features and vulnerability.

    Matched MeSH terms: Female
  14. Ab Aziz M, Ai Kah N, Ismail M, Majid HA
    Asia Pac J Public Health, 2024 Jul;36(5):437-446.
    PMID: 38695359 DOI: 10.1177/10105395241248545
    Low- and lower-middle-income countries bear the greatest burden of anemia, particularly those living in rural settings such as an indigenous community. The objective of this systematic review was to determine the prevalence of anemia and its determinants among the Orang Asli children in Peninsular Malaysia. A web-based search of PubMed, Web of Science, Scopus, Medline, and ProQuest from January 2000 to June 2022, using specified search/MeSH (Medical Subject Headings) terms and keywords, was conducted. The search identified studies reported the prevalence of anemia among the children of Orang Asli and its causes. Eight studies were included in the final analysis. The prevalence of anemia among the Orang Asli children was high (61.6%). Most research has focused primarily on iron-deficiency anemia and soil-transmitted helminth infections. Other causes include female gender, mothers with low education levels, and low household incomes. Despite being a public health concern, this study found no studies associating Orang Asli children with hereditary anemia and malaria, which is a limitation. In conclusion, the Orang Asli children are more likely to have anemia compared with the general Malaysian population. To overcome this, a comprehensive examination of the determinants of anemia in this community is required. Thus, interventions can be personalized.
    Matched MeSH terms: Female
  15. Raza A, Jauhar J, Abdul Rahim NF, Memon U, Matloob S
    PLoS One, 2023;18(10):e0288527.
    PMID: 37796908 DOI: 10.1371/journal.pone.0288527
    In Pakistan, women outnumber men in medical colleges with 80 percent enrollment, yet many fail to practice medicine following graduation. Pakistan Medical Council (PMC) states 50 percent of graduated women doctors either did not practice or left employment in a short period. Thus, the non-servicing women doctors are assumed as the one of the major causes for the overall doctors' shortage in the country. Addressing this enduring matter, this study aims to explore and understand the factors that discourage women doctors from practicing medicine in Pakistani hospitals. The study employed qualitative exploratory inquiry with an interpretive paradigm to attain a deeper understanding of the problem. 59-semi structured interviews were conducted by non-working women doctors across the entirety of Pakistan. The narratives were then analyzed by thematic analysis using ATLAS.ti 22. The findings have resulted in the three major themes, i.e., workplace challenges, socio-cultural obstructions, and familial restrictions that possibly obstruct women from practicing medicine in hospitals. The findings suggested that accepting traditional cultural values, including entrenched gender roles in society, deters women from practicing medicine. The prevailing patriarchal societal system includes stereotypes against working women; early marriages hinder women from practicing medicine. The prevailing societal system upholds the influence of in-laws and a husband for women doctor professional employment. As a result, severe work-life conflict was reported where most women doctors ended up in their profession in the middle of struggling between socially rooted gender roles as homemakers and their professional careers-furthermore, the study found various workplace issues that posit an additional burden on already struggling women doctors. Issues include poor recruitment and selection process, transfer constraints, excessive workload with inadequate salary, harassment, gender discrimination, unsafe work environment, and little support from the administration highly contribute to the shortage of women doctors in Pakistan.
    Matched MeSH terms: Female
  16. Lee JK
    Arch Osteoporos, 2025 Jan 23;20(1):11.
    PMID: 39847260 DOI: 10.1007/s11657-024-01482-4
    Osteoporosis, fragility fractures, and bone health optimization share the same pathophysiology, diagnostic tools, risk assessment, and treatments. Grouping them into "Lee's TRIAD" allows surgeons and physicians to collaborate more efficiently, using unified principles and strategies for managing these conditions.

    PURPOSE: The primary goal of osteoporosis management is to prevent fragility fractures, which occur from falls from standing height or less in individuals over fifty. However, the management of bone health optimization is often neglected in patients undergoing elective surgeries, such as arthroplasty and spinal surgeries. The objective of this article is to link all these three conditions into a TRIAD so that surgeons and physicians can collaborate more effectively, utilizing similar principles and strategies for better management.

    METHODOLOGY: Clinical approaches based on country-specific guidelines are commonly used to manage osteoporosis. However, skeletal assessments are rarely conducted before or after elective procedures, leading to overlooked conditions such as osteoporosis, osteopenia, and fragility fracture risk factors. These three conditions are illustrated from the patient case study shown, to highlight the importance of not neglecting bone health optimization in high risk individuals undergoing elective surgery, with underlying osteopenia and multiple risk factors who sustained fragility fracture intraoperatively.

    RESULT: Patients undergoing elective surgeries often have their bone health neglected, leading to a higher incidence of complications such as aseptic loosening and peri-prosthetic fractures due to poor bone quality and density. Bone health assessment and optimization therefore is essential in patients with osteoporosis, osteopenia with clinical risk factors, and patients with history of fragility fracture, to ensure implants sit on bone with good density and quality to minimize the complications.

    CONCLUSION: By combining osteoporosis, fragility fractures, and bone health optimization into a TRIAD, "Lee's TRIAD," surgeons and physicians can collaborate more effectively, utilizing similar principles and strategies for better management.

    Matched MeSH terms: Female
  17. Lynch M
    Soc Sci Med, 2025 Jan;365:117592.
    PMID: 39644779 DOI: 10.1016/j.socscimed.2024.117592
    This research highlights the ways by which processes of caring for our environments can contribute to health and well-being for the minded body. Drawing upon rich ethnographic accounts of urban cultivation practices and experiences, this research unfolds in the birthplace of the 'Healthy City' concept-Kuching, Malaysia-which is an ethnically diverse city home to Chinese, Malay, Indigenous and other groups. Building from situated political ecologies-and more specifically, emotional political ecology and the political ecology of religion-I examine the relational values produced through practices of urban cultivation and related benefits for mind-body-environments. I find spirituality, religion, gender, generation, class, and ethnicity are embodied in socionatural relationships facilitated through urban agriculture. Through affective encounters with non-human animals, spiritual meanings inferred from the materiality of plants, and strengthened socionatural relationships with friends, family, even strangers, and the divine, practices of urban cultivation can nurture minds, bodies, and environments in deeply interconnected ways. This adds to a growing literature that reveals the importance of relational values for well-being and argues that socionatural relationships of care can contribute to a meaningful life. With a careful attention to relational dynamics and differentiated embodied experiences, I show that cultivators engage in the production of ecologies of care that confront neoliberal modes of interacting with themselves and others. Recognizing that care is embodied, situated and political can foster more nuanced understandings of the politics of socioecological transformation.
    Matched MeSH terms: Female
  18. Kamarudin SS, Idris IB, Sharip S, Ahmad N
    JMIR Res Protoc, 2025 Jan 27;14:e63564.
    PMID: 39869891 DOI: 10.2196/63564
    BACKGROUND: Postpartum depression remains a significant concern, posing substantial challenges to maternal well-being, infant health, and the mother-infant bond, particularly in the face of barriers to traditional support and interventions. Previous studies have shown that mobile health (mHealth) interventions offer an accessible means to facilitate early detection and management of mental health issues while at the same time promoting preventive care.

    OBJECTIVE: This study aims to evaluate the effectiveness of the Leveraging on Virtual Engagement for Maternal Understanding & Mood-enhancement (LoVE4MUM) mobile app, which was developed based on the principles of cognitive behavioral therapy and psychoeducation and serves as an intervention to prevent postpartum depression.

    METHODS: This single-blinded, pilot randomized controlled trial includes 64 mothers recruited from the postnatal ward and randomized using a 1:1 ratio to receive either postpartum care (treatment as usual) or postpartum care (treatment as usual) plus the self-guided LoVE4MUM mobile app. The primary outcome is the effectiveness of the mobile app at improving postpartum depression. Secondary outcomes are changes in the mental health literacy score and negative automatic thoughts, which are collected using a self-reported questionnaire.

    RESULTS: Patient recruitment began on September 1, 2024. As of January 1, 2025, recruitment was successfully completed, with a total of 72 participants enrolled: 36 in the intervention group and 36 in the control group . The final results are anticipated to be available by March 2025, and publication is expected by the end of 2025.

    CONCLUSIONS: By examining the LoVE4MUM app alongside standard postpartum care, this pilot randomized controlled trial seeks to offer preliminary evidence on the potential of mHealth tools to improve maternal mental health as well as to reduce postpartum depression symptoms. The findings are expected to contribute to the future development of effective, accessible, and scalable interventions for mothers.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT06366035; https://clinicaltrials.gov/study/NCT06366035.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/63564.

    Matched MeSH terms: Female
  19. Mohd-Zahir NA, Mohd-Kamal FN, Sipin Q, Ammar-Qusyairi MH, Moktar MA, Low SY, et al.
    Trop Biomed, 2024 Dec 01;41(4):399-403.
    PMID: 39876495 DOI: 10.47665/tb.41.S.003
    Canine haemotrophic mycoplasmosis is caused by mycoplasma haemopathogens, which includes Mycoplasma haemocanis (Mhc) and Candidatus Mycoplasma haematoparvum (CMhp). The Mhc and CMhp pose a health risk to dogs, particularly in immunocompromised and splenectomised dogs, as they lead to haemolytic anaemia. There is scarce information on the detection of Mycoplasma in dogs in Malaysia. Therefore, this study aims to detect the presence of Mycoplasma in the blood of shelter and pet dogs and identify associated risk factors in Malaysian dog populations. Blood samples from shelter dogs in Selangor (n = 71) and pet dogs in Johor Bahru (n = 169) were collected. Conventional polymerase chain reaction (PCR) was used to detect Mycoplasma 16S rRNA. Overall, 21.7% of the tested samples were positive, with a higher prevalence among the shelter dogs (45.1%) than pet dogs (11.8%). The Mhc was the predominant species detected, with only one case of CMhp. Risk factors associated with Mycoplasma infection in shelter dogs included urban areas, and the presence of rodents, and wild animals, but no significant associations with tick infestations were detected. These findings necessitate the importance of Mycoplasma transmission dynamics among Malaysian dog populations to assist in the implementation of control measures.
    Matched MeSH terms: Female
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