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  1. Lau YH, Mawardi AS, Zain NR, Viswanathan S
    Pract Neurol, 2021 Oct;21(5):439-441.
    PMID: 34039751 DOI: 10.1136/practneurol-2021-002942
    A 33-year-old man with a history of chronic toluene abuse through glue sniffing, developed tremors, cerebellar signs and cognitive decline. MR scan of the brain showed global cerebral and cerebellar atrophy with symmetrical T2-weighted hypointensities in the basal ganglia, thalami and midbrain. After stopping glue sniffing, his tremors, ataxia of gait, speech and cognition partially improved. Early recognition and intervention of toluene-induced leukodystrophy could prevent ongoing morbidity and premature mortality.
  2. Saleem H, Zaidi SJ, Ismail AF, Goh PS
    Chemosphere, 2022 Jan;287(Pt 2):132083.
    PMID: 34488054 DOI: 10.1016/j.chemosphere.2021.132083
    One of the most favorable environmental applications of nanotechnology has been in air pollution remediation in which different nanomaterials are used as nanoadsorbents, nanocatalysts, nanofilters, and nanosensors. The nanomaterials have the ability to adsorb several contaminants existing in the air. Also, certain semiconducting nanomaterials materials can be used for photocatalytic remediation. Air contamination control can also be achieved by nanostructured membranes with pores sufficiently small to separate various pollutants from the exhaust. Nanomaterial enabled sensors are also used for the detection of harmful gases such as hydrogen sulfide, sulphur dioxide, and nitrogen dioxide. Conversely, because of the uncertainties in addition to irregularities in size, shape as well as chemical compositions, the existence of some nanomaterials might cause harmful effects on the environment along with the health of people. Thus, concerns were expressed about the transport and conversion of nanoparticles discharged into the surroundings. This review critically examined and assessed the present literature on the application of nanomaterials in the air, together with its negative impacts. The main focus is placed on the application of carbon-based and metal-based nanomaterials for air pollution remediation. It is noted that these nanomaterials demonstrating fascinating properties for improving the environmental pollution remediation system.
  3. Md Yusof M, Abdullah MM, Yap BK, Ng SC, Low JSH, Lam KS, et al.
    Asia Pac J Clin Oncol, 2021 Nov 23.
    PMID: 34811924 DOI: 10.1111/ajco.13667
    AIM: A large proportion of cancer patients are at high risk for chemotherapy-induced nausea and vomiting (CINV), but the choice of anti-emetics for CINV in Malaysia is limited.

    METHODS: This was a real-world study of a fixed-dose combination of netupitant and palonosetron (NEPA) to inhibit CINV in adult patients receiving moderately (MEC) or highly emetogenic chemotherapy (HEC) for solid/hematological malignancies at eight Malaysian centers. Each HEC/MEC cycle received one dose of NEPA + dexamethasone for CINV prevention. Complete response (no emesis, no rescue medication) (CR), no more than mild nausea (severity score ≤ 2.5), and complete control (CR) (no more than mild nausea) during the acute (0-24 h), delayed (25-120 h), and overall (0-120 h) phases post-chemotherapy were measured. Treatment-related adverse events (AEs) were recorded.

    RESULTS: During March 2016-April 2018 (NMRR-17-3286-38282), NEPA + dexamethasone was administered to 54 patients (77.8% solid, 22.2% hematological malignancies). Note that 59.3% received HEC, while 40.7% received MEC regimen. During the overall phase of the first cycle, the majority had CR (77.8%), no more than mild nausea (74.1%), and complete control (61.1%). Seventeen patients received two consecutive cycles at any point of chemotherapy cycles. During the overall phases across two consecutive cycles, all patients achieved CR, and the majority reported no more than mild nausea and complete control. No grades 3-4 AEs were reported.

    CONCLUSIONS: NEPA had sustained efficacy and tolerability at first administration and across two cycles of MEC/HEC for CINV prevention.

  4. Farah NM, Amran AD, Che Muhamed AM
    J Sports Sci, 2021 Dec;39(24):2755-2762.
    PMID: 34323655 DOI: 10.1080/02640414.2021.1957294
    Exaggerated cardiovascular (CV) reactivity to stress is associated with negative cardiovascular outcomes. This study aimed to investigate the effects of acute high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on CV reactivity in response to a stress challenge in untrained males. Thirteen, normotensive males (age: 22.8 ± 2 years, BMI: 21.9 ± 3.6 kg/m2) underwent three conditions in counterbalanced order: HIIE (bodyweight exercises; 80-90% HRR), MIE (treadmill-jog; 55-60% HRR) and seated rest (CON) separated by 7-10 days. Thirty minutes after performing HIIE, MIE or CON, subjects underwent a 2-min cold pressor task (CPT). Blood pressure (BP) and heart rate (HR) were measured before, during, and after CPT. CV reactivity, i.e., the change in BP and HR responses were compared across conditions. Systolic BP reactivity were attenuated following HIIE (-60%, p = 0.015) and MIE (-42%, p = 0.033) compared to CON, but no differences were observed between HIIE and MIE. HR reactivity was not different across all conditions. We conclude that performing HIIE or MIE 30 minutes prior to acute stress exposure lowers BP reactivity compared to rest in untrained males. These findings highlight the potential benefits of HIIE in lowering stress-induced elevations in blood pressure.
  5. Mat Johar F, Halim AS, Wan Sulaiman WA, Muhamad H
    Burns, 2021 11;47(7):1683-1687.
    PMID: 33715940 DOI: 10.1016/j.burns.2021.02.007
    INTRODUCTION: Health campaigns include physical campaigns in schools, community halls, or community malls. They can also be broadcast via television, newspaper, and radio. We launched a health campaign on social media platforms that have a powerful impact in this digital era.

    METHODS: A three-dimensional short animation was developed for the Burn and Blast Injury Awareness campaign. It was launched during the fasting month and Eid 2020 when firecracker-related injuries are highly incident in Malaysia. The video was launched primarily on Universiti Sains Malaysia (USM) and Wau Animation Sdn Bhd social media platforms. Each party shared the video on the top 3 social media platforms, which are Facebook, Instagram, and YouTube. The numbers of viewers, reaches, and shares, and demographic data were captured at 1 month after the release.

    RESULTS: We recorded 29,585 views, 60,920 reach, and 874 shares from the USM and Wau Animation platforms alone. The USM Facebook platform showed predominant female viewership (60%), whereas the Wau Facebook platform showed predominant male viewership (66%). In both platforms, the viewers were aged 18-34 years.

    CONCLUSION: Health awareness campaigns on digital platforms are powerful because the message spreads faster, and it is also safe during the pandemic.

  6. Elumalai G, Hashim A, Sankaravel M, Chia RR
    MyJurnal
    This study is aimed to evaluate the obesity level and promote a healthy lifestyle among students at Universiti Pendidikan Sultan Idris, Perak. Fifteen male and fifteen female undergraduate students aged between 19 years to 24 years from each faculty of university Pendidikan Sultan Idris are randomly selected as samples (n=270). The Body Mass Index (BMI) and modified questionnaires by Burton (1999) are used as instruments for this study. Analysis showed that 15.9% of the respondents are overweight, 23.7% are in pre-obese level, 27.8% are in obese level one and 3.7% respondents are in obese level two. T-test analysis of independent samples was used to determine the level of knowledge and a healthy lifestyle among male and female students. The results showed that there is no significant difference between male and female students in the levels of healthy lifestyle practices with p = 0.089 (p> 0.05); the level of a healthy lifestyle practices among males (M = 71.57, SD = 8:42) have almost the same mean with females (M = 70.05, SD = 6:00). Furthermore, the findings indicate that the scores on the levels of knowledge on healthy lifestyle for male students is (M = 79.09, SD = 7:38), while the mean score for female students is (M = 76.95, SD = 8:59) with p = 0.028 (p <0.05). On comparing the means of the scores on the levels of knowledge on healthy lifestyle, the male students scored higher than the female students. It turns out there is a difference between male and female students in terms of the level of knowledge on healthy lifestyle. The study found that the respondents have a good knowledge on healthy lifestyle, but lack practice in daily life. This is an unpleasant indication because Universiti Pendidikan Sultan Idris students are facing the risk of cardiovascular-related diseases caused by obesity and a sedentary lifestyle.
    Study site: Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
  7. Hadi DA, Mohamed AR, Rethanavelu K, Khoo TB
    Brain Dev, 2022 Jan;44(1):44-49.
    PMID: 34483011 DOI: 10.1016/j.braindev.2021.08.006
    BACKGROUND: Ferric chelate reductase 1 like (FRRS1L) encephalopathy is a rare cause of developmental and epileptic encephalopathy. Only a few cases have been reported thus far and seizures tend to be drug refractory. We report an additional case to highlight the good seizure response to sulthiame.

    CASE REPORT: A boy from non-consanguineous parents presented with history of 'abnormal movements' from 7 months of age. At one year of age, video electroencephalogram (EEG) monitoring demonstrated the 'abnormal movements' to be clonic seizures. Valproate, lamotrigine and clobazam combination were only partially effective at reducing the seizures. Repeat EEG at 1 year 8 months old revealed a continuous spikes-and-waves during slow sleep (CSWS) pattern, prompting a trial of sulthiame. After 2 weeks of sulthiame, seizures ceased completely. The clonic seizures recurred at age 4 years when sulthiame supply was interrupted, but the seizures promptly remitted following sulthiame's resumption. Subtle choreiform movements appeared from age one year and later became more prominent. Whole exome sequencing (WES) identified a homozygous novel variant (nonsense) in the FRRS1L gene (NM_014334.3: c.670C>T:p.Gln224*). He has been seizure free since 4 years of age but remained profoundly delayed.

    CONCLUSION: Sulthiame may have a role in the early treatment of seizures in children with refractory epilepsy due to FRRS1L mutation.

  8. Ong WF, Musa AT, Ooi LW, Karim NKA
    J Taibah Univ Med Sci, 2021 Dec;16(6):943-947.
    PMID: 34899138 DOI: 10.1016/j.jtumed.2021.07.007
    Primary osteosarcomas involving the base of the skull in middle-aged patients are rare. We describe the case of a 59-year-old Asian woman presenting with lethargy, epistaxis, left maxillary and mandibular pain, and headache. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large left greater sphenoid wing tumour with extensive local infiltration and intracranial extension. The tumour was diagnosed as osteosarcoma based on histological examination. In this report, we discuss the clinical presentations, radiological features, and imaging differential diagnoses of this case.
  9. Badai SS, Rasid OA, Parveez GKA, Masani MYA
    3 Biotech, 2020 Dec;10(12):530.
    PMID: 33214977 DOI: 10.1007/s13205-020-02514-9
    Cetyltrimethylammonium bromide (CTAB) is the preferred detergent in RNA extraction of oil palm tissues. However, the CTAB-based protocol is time-consuming. In this study, a combination of the CTAB-based method and silica-based purification reduced the extraction time from two days to five hours. Quality of total RNA from 27 different tissues of oil palm was shown to have an RNA integrity number (RIN) value of more than seven. The extracted RNA was evaluated by RT-qPCR using three reference oil palm genes (GRAS, CYP2, and SLU7) and three putative mesocarp-specific transcripts annotated as WRKY DNA-binding protein 70 (WRKY-70), metallothionein (MT) and pentatricopeptide repeat (PPR) genes. Tissue-specific expression profiling across complete developmental stages of mesocarp and vegetative tissues was determined in this study. Overall, the RNA extraction protocol described here is rapid, simple and yields good quality RNAs from oil palm tissues.
  10. Karnati PKR, Seth P, Zamzuri ATB, Tharwani P
    Case Rep Dent, 2021;2021:8290429.
    PMID: 34976417 DOI: 10.1155/2021/8290429
    Orthodontic-induced external apical root resorption is one of the idiopathic phenomena as an effect, with force generated through mechanotherapy as the cause and the biological tissues with their diversified variations as witness. It is also classified as iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing underlying conditions. Numerous factors were identified to relate to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers have proved the reliability with time, but the application became insignificant limiting mostly to the research field. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly, it is identified through routine radiographic stage records like orthopantomogram or certain prediction radiographs for root resorption probability assessment like in this case. This case report discusses one such encounter which was experienced after stage 1 and 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology, the ongoing treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual. Furthermore, the prognosis is compromised to be very poor with unpredictability to any other treatment modalities.
  11. Daud AZC, Aman NA, Chien CW, Judd J
    F1000Res, 2020;9:1306.
    PMID: 34950457 DOI: 10.12688/f1000research.25753.1
    Background: Little is known on how time spent on touch-screen technology affects the hand skills development of preschool children. This study aimed to investigate the effects of touch-screen technology usage on hand skills among preschool children. Methods: Case-control design was employed to compare the hand skills of children who were engaged in touch-screen technology. A total of 128 participants aged between five and six years old who attended preschool were recruited and divided into two groups: high usage touch-screen technology (HUTSTG) and, low usage touch-screen technology (LUTSTG). Children's Hand Skills ability Questionnaire (CHSQ) and Assessment of Children's Hand Skills (ACHS) were used to evaluate the children's hand skills. Results: There were significant differences in the hand skills of preschool children between HUTSTG and LUTSTG. Results showed that preschool children in LUTSTG had better hand skills in all domains of CHSQ (p≤0.001) and ACHS (p<0.001) as compared to HUTSTG. Conclusion: Frequent use of touch-screen technology might cause disadvantages to the development of hand skills among preschool children.
  12. Ishak R, Ahmad R, Gudum HR, Hassan K, Ang ES
    Malays J Reprod Health, 1992 Jun;10(1):7-11.
    PMID: 12345026
    PIP: Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.
  13. Juvale IIA, Hassan Z, Has ATC
    Int J Med Sci, 2021;18(16):3851-3860.
    PMID: 34790061 DOI: 10.7150/ijms.60928
    Cancer is one of the leading causes of death in both developed and developing countries. Due to its heterogenous nature, it occurs in various regions of the body and often goes undetected until later stages of disease progression. Feasible treatment options are limited because of the invasive nature of cancer and often result in detrimental side-effects and poor survival rates. Therefore, recent studies have attempted to identify aberrant expression levels of previously undiscovered proteins in cancer, with the hope of developing better diagnostic tools and pharmaceutical options. One class of such targets is the π-subunit-containing γ-aminobutyric acid type A receptors. Although these receptors were discovered more than 20 years ago, there is limited information available. They possess atypical functional properties and are expressed in several non-neuronal tissues. Prior studies have highlighted the role of these receptors in the female reproductive system. New research focusing on the higher expression levels of these receptors in ovarian, breast, gastric, cervical, and pancreatic cancers, their physiological function in healthy individuals, and their pro-tumorigenic effects in these cancer types is reviewed here.
  14. Damulira E, Yusoff MNS, Omar AF, Mohd Taib NH
    Phys Med Biol, 2021 Apr 12;66(8).
    PMID: 33725685 DOI: 10.1088/1361-6560/abef44
    Light-emitting diodes (LEDs) could be a potential dosimetry candidate because they are radiation hard, spectrally selective, direct band gap, and low-cost devices. Thus, an LED-based detector prototype was designed and characterized for dosimetry. A 20 × 20 cm2array of surface mount device LED chips was sandwiched in photovoltaic mode between two intensifying screens to form a dosimetric system. The system was enclosed in a light-tight air cavity using black vinyl tape. The screens converted diagnostic x-ray beams into fluorescent blue light. LEDs, applied in detector mode, converted the fluorescent light into radiation-induced currents. A digital multimeter converted the analog currents into digital voltage signals. Prototype characterization was executed using (a) IEC 61267's RQR 7 (90 kVp) and RQR 8 (100 kVp) beam qualities, and (b) low (25 mAs) and high (80 mAs) beam quantities. A standard dosimeter probe was simultaneously exposed with the prototype to measure the prototype's absorbed dose. In all exposures, the x-ray beams were perpendicularly incident on both the dosimeter and prototype, at a fixed source to detector distance-60 cm. The LED array prototype's minimum detectable dose was 0.139 mGy, and the maximum dose implemented herein was ∼13 mGy. The prototype was 99.18% and 98.64% linearly sensitive to absorbed dose and tube current-time product (mAs), respectively. The system was ±4.69% energy, ±6.8% dose, and ±7.7% dose rate dependent. Two prototype data sets were 89.93% repeatable. We fabricated an ultrathin (5 mm), lightweight (130 g), and a relatively low-cost LED-based dosimetric prototype. The prototype executed a simple, efficient, and accurate real-time dosimetric mechanism. It could thus be an alternative to the current passive dosimetric systems.
  15. Tan B, Philipp MC, Che Muhamed AM, Mundel T
    J Appl Physiol (1985), 2022 Jan 27.
    PMID: 35085028 DOI: 10.1152/japplphysiol.00402.2021
    Chronic pain is a pervasive health problem and is associated with tremendous socioeconomic costs. However, current pain treatments are often ineffective due, in part, to the multi-factorial nature of pain. Mild hypohydration was shown to increase experimental pain sensitivity in men, but whether this also occurs in women has not been examined. Fluctuations in ovarian hormones (i.e., 17ß-oestradiol and progesterone) throughout the menstrual cycle may influence a woman's pain sensitivity, as well as hydration levels, suggesting possible interactions between hypohydration and menstrual phase on pain. We investigated the effects of mild hypohydration (HYPO, 24 hr of fluid restriction) on ischaemic pain sensitivity in 14 eumenorrheic women during the early follicular (EF) and mid-luteal (ML) phases of their menstrual cycle. We also examined whether acute water ingestion could reverse the negative effects of hypohydration. Elevated serum osmolality, plasma copeptin, and urine specific gravity indicated mild hypohydration. Compared to euhydration, HYPO reduced pain tolerance (by 34 ± 46 s; P = 0.02, ηp2 = 0.37) and increased ratings of pain intensity (by 0.7 ± 0.7 cm; P = 0.004; ηp2 = 0.55) and unpleasantness (by 0.7 ± 0.9 cm; P = 0.02; ηp2 = 0.40); these results were not influenced by menstrual phase. Water ingestion reduced thirst perception (Visual Analogue Scale, by 2.3 ± 0.9 cm; P < 0.001, ηp2 = 0.88) but did not reduce pain sensitivity. Therefore, hypohydration increases pain sensitivity in women with no influence of menstrual phase.
  16. Wan Musa WZ, Abu Bakar NAF, Ahmad A, Naing NN
    Med J Malaysia, 2022 Jan;77(1):71-81.
    PMID: 35086997
    INTRODUCTION: High intakes of total fat are long known as a risk factor for coronary heart disease (CHD), but the association between fatty acids and CHD remains unclear. This scoping review aims to collate and analyze the association between types of fatty acid and risk of CHD.

    MATERIALS AND METHODS: This review uses the methodological framework of Arksey and O'Malley. A total of 19 studies were selected from 9456 studies screened from the electronic databases.

    RESULTS: Majority of the studies reported no association between saturated fat (SFA) and monounsaturated fat (MUFA) with CHD. Meanwhile, seven out of 12 studies reported inverse association between polyunsaturated fat (PUFA) and risk of CHD whilst 67% of the studies found that trans-fat intake was positively associated with CHD risk.

    CONCLUSIONS: This review finds that all the types of dietary fat have different effects on the risk of CHD. Nevertheless, intakes of healthy fat such as MUFA and PUFA in controlled amounts are expected to reduce CHD risk. In addition, the divergence of findings found between studies might be due to the methodological inconsistencies. More robust research is needed to determine the actual dietary determinants of CHD as it will provide important information for future development of dietary intervention.

  17. Ahmad F, Bakar SA, Ibrahim AZ, Read RW
    Planta Med, 1997 Apr;63(2):193-4.
    PMID: 17252347
  18. Siti HN, Jalil J, Asmadi AY, Kamisah Y
    Cardiovasc Drugs Ther, 2022 02;36(1):15-29.
    PMID: 33064235 DOI: 10.1007/s10557-020-07100-y
    PURPOSE: Cardiac dysfunction can occur as a sequela of a state of prolonged pressure overload and postischemic injury. Flavonoids such as quercetin may be protective against cardiovascular disease. This study aimed to systematically assess the effects of quercetin on cardiac function in pressure overload and postischemia-reperfusion injury in rodents.

    METHODS: A systematic search of the literature up to May 2020 was conducted in PubMed, Ovid Medline, EBSCOhost, Scopus, and the Cochrane Library to identify relevant published studies on quercetin and cardiac function using standardized criteria. Meta-analyses were performed on animal studies of pressure overload and ischemia-reperfusion (I/R) injury.

    RESULTS: The effects of quercetin on cardiac function in both models were qualitatively reported in 14 studies. The effects of quercetin in four pressure-overload model studies involving 73 rodents and eight I/R-injury model studies involving 120 rodents were quantitatively assessed by meta-analysis. Quercetin improved the overall cardiac function in both pressure overload (n = 4 studies, n = 73 rodents; SMD = - 1.50; 95% CI: - 2.66 to - 0.33; P 

  19. Azemi AK, Mokhtar SS, Sharif SET, Rasool AHG
    Pharm Biol, 2021 Dec;59(1):1432-1440.
    PMID: 34693870 DOI: 10.1080/13880209.2021.1990357
    CONTEXT: Atherosclerosis predisposes individuals to adverse cardiovascular events. Clinacanthus nutans L. (Acanthaceae) is a traditional remedy used for diabetes and inflammatory conditions.

    OBJECTIVES: To investigate the anti-atherosclerotic activity of a C. nutans leaf methanol extract (CNME) in a type 2 diabetic (T2D) rat model induced by a high-fat diet (HFD) and low-dose streptozotocin.

    MATERIALS AND METHODS: Sixty male Sprague-Dawley rats were divided into five groups: non-diabetic fed a standard diet (C), C + CNME (500 mg/kg, orally), diabetic fed an HFD (DM), DM + CNME (500 mg/kg), and DM + Metformin (DM + Met; 300 mg/kg). Treatment with oral CNME and metformin was administered for 4 weeks. Fasting blood glucose (FBG), serum lipid profile, atherogenic index (AI), aortic tissue superoxide dismutase levels (SOD), malondialdehyde (MDA), and tumour necrosis factor-alpha (TNF-α) were measured. The rats' aortas were stained for histological analysis and intima-media thickness (IMT), a marker of subclinical atherosclerosis.

    RESULTS: The CNME-treated diabetic rats had reduced serum total cholesterol (43.74%; p = 0.0031), triglycerides (80.91%; p = 0.0003), low-density lipoprotein cholesterol (56.64%; p = 0.0008), AI (51.32%; p 

  20. Rashedi A, Marzouki R, Raza A, Rawi NFM, Naveen J
    Polymers (Basel), 2021 Nov 08;13(21).
    PMID: 34771412 DOI: 10.3390/polym13213852
    For a sustainable environment, geopolymer (GPO) paste can be used in the construction industry instead of Portland cement. Nowadays, sustainable construction and high-efficacy composites are demanding. Therefore, in the present investigation, the mechanical and microstructural efficacy of carbon-fiber-reinforced fly ash-based GPO with different percentages of nano-sodium dioxide (NS) were studied. The investigated percentages of NS were 0%, 1%, 2%, 3%, and 4%. For all the samples, the carbon fiber content was kept the same at 0.5% by weight. Different percentages of NS for all five fabricated GPO composite pastes were assessed with scanning electron microscopy (SEM). Various mechanical parameters of GPO-the compressive strength, toughness modulus, hardness, toughness indices, impact strength, fracture toughness, flexural strength, and elastic modulus-were evaluated. The results revealed that the use of 3% NS was the most effective for ameliorating the mechanical, microstructural, and fracture behavior of GPO. The use of 3% NS in carbon-fiber-reinforced GPO paste showed the maximum improvements of 22%, 46%, 30%, 40%, 14%, 38.4%, 50.2%, 31%, and 64% for the compressive strength, flexural strength, elastic modulus, toughness modulus, hardness, compressive stiffness, bending stiffness, fracture toughness, and impact strength, respectively. The SEM study showed that the inclusion of NS improved the microstructure and delivered a denser GPO paste by improving the interfacial zones and quickening the polymerization reaction.
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